Provider Demographics
NPI:1316148687
Name:CHRIS L. STURCH, M.D., INC.
Entity type:Organization
Organization Name:CHRIS L. STURCH, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:STURCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-924-8100
Mailing Address - Street 1:1727 CHUCKWA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2151
Mailing Address - Country:US
Mailing Address - Phone:580-924-8100
Mailing Address - Fax:580-924-8105
Practice Address - Street 1:1727 CHUCKWA DR
Practice Address - Street 2:SUITE 400
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2151
Practice Address - Country:US
Practice Address - Phone:580-924-8100
Practice Address - Fax:580-924-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200012060AMedicaid
OK200012060AMedicaid