Provider Demographics
NPI:1063564011
Name:FROST, CHRISTOPHER JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:FROST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 TRADEPARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3454
Mailing Address - Country:US
Mailing Address - Phone:606-679-9292
Mailing Address - Fax:606-679-9294
Practice Address - Street 1:120 TRADEPARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3454
Practice Address - Country:US
Practice Address - Phone:606-679-9292
Practice Address - Fax:606-679-9294
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29366207ND0101X, 207N00000X, 207NS0135X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000048630OtherANTHEM
070007464OtherRAILROAD MEDICARE
KY64293665Medicaid
AF3048508OtherDEA
070007464OtherRAILROAD MEDICARE
KY64293665Medicaid