Provider Demographics
NPI:1104251784
Name:BETTIS, CHRISTOPHER SCOTT (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:BETTIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8080 ACADEMY RD NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1159
Mailing Address - Country:US
Mailing Address - Phone:505-244-0080
Mailing Address - Fax:505-244-9048
Practice Address - Street 1:8080 ACADEMY RD NE
Practice Address - Street 2:SUITE B
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1159
Practice Address - Country:US
Practice Address - Phone:505-244-0080
Practice Address - Fax:505-244-9048
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMPA2013-0059363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical