Provider Demographics
NPI:1316922289
Name:RODMAN, WILLIAM JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:RODMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:225 N MILL ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1559
Mailing Address - Country:US
Mailing Address - Phone:970-544-3991
Mailing Address - Fax:970-544-0136
Practice Address - Street 1:225 N MILL ST
Practice Address - Street 2:SUITE 114
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1559
Practice Address - Country:US
Practice Address - Phone:970-544-3991
Practice Address - Fax:970-544-0136
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32831208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COA16546Medicare UPIN
CO77191Medicare ID - Type Unspecified