Christopher Jon Stark
Internal Medicine in Pueblo, CO. Individual provider (NPI-1).
NPI number1013936764
StatusActive
Last updated in NPPESMay 12, 2023
Details
- NPI
- 1013936764
- Entity type
- Individual (NPI-1)
- Name
- Christopher Jon Stark
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 19, 2006
- Certification date
- May 12, 2023
- Last updated
- May 12, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - HOSPITALIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | DR.0058428 | CO | Yes |
| 207R00000X | Internal Medicine | 39876 | KY | |
| 207RC0200X | Internal Medicine, Critical Care Medicine | 50157 | MN | |
| 208M00000X | Hospitalist | DR.0058428 | CO |
Other names
- Christoper J Stark (Professional Name)
Practice location
400 W 16th StPueblo, CO 81003-2745
Phone 719-595-2218 · Fax 719-595-7994
Mailing address
Po Box 560825Denver, CO 80256-0825
Phone 719-595-7580 · Fax 719-545-0176
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