Provider Demographics
NPI:1386691996
Name:CHRISTIAN, JAMES DEARING (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEARING
Last Name:CHRISTIAN
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:PO BOX 72059
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97475-0285
Mailing Address - Country:US
Mailing Address - Phone:541-341-8063
Mailing Address - Fax:541-341-8099
Practice Address - Street 1:1775 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2125
Practice Address - Country:US
Practice Address - Phone:541-341-8063
Practice Address - Fax:541-341-8099
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47207207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ47207OtherMEDICAL LICENSE
NCP00996854OtherRAILROAD MEDICARE
VAPENDINGMedicaid
NC9487084OtherAETNA
I60933Medicare UPIN
VAPENDINGMedicare PIN
NCP00996854OtherRAILROAD MEDICARE