Provider Demographics
NPI:1336775204
Name:DENHAM, CHRISTOPHER ROBIN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROBIN
Last Name:DENHAM
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 1:168 CREST DR
Mailing Address - Street 2:
Mailing Address - City:COCHRAN
Mailing Address - State:GA
Mailing Address - Zip Code:31014-8022
Mailing Address - Country:US
Mailing Address - Phone:909-485-4828
Mailing Address - Fax:
Practice Address - Street 1:5566 THOMASTON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31220-8118
Practice Address - Country:US
Practice Address - Phone:478-476-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN720232084P0800X
GA925272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry