Provider Demographics
NPI:1306872114
Name:BOOKOUT, CHRISTOPHER B (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:BOOKOUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5750 BERRYHILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-8276
Mailing Address - Country:US
Mailing Address - Phone:850-623-0543
Mailing Address - Fax:850-623-5479
Practice Address - Street 1:5750 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-8276
Practice Address - Country:US
Practice Address - Phone:850-623-0543
Practice Address - Fax:850-623-5479
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78243207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259799300Medicaid
FL7939142OtherAETNA
FL49762OtherBCBS
FLA901OtherHEALTHFIRST NETWORK
AL009951725OtherALACAID
FL0900364OtherUNITED HEALTHCARE
FL200039157OtherRAILROAD MEDICARE
AL59018844OtherBCBS
FL259799300Medicaid
FL7939142OtherAETNA
FL200039157OtherRAILROAD MEDICARE