Provider Demographics
NPI:1386870046
Name:SPERRY, CHRISTOPHER LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LYNN
Last Name:SPERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 636961
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6961
Mailing Address - Country:US
Mailing Address - Phone:513-981-5130
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:234 AMY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-2522
Practice Address - Country:US
Practice Address - Phone:270-538-5596
Practice Address - Fax:270-538-5597
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31727207Q00000X
KY45425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100209840Medicaid
KYK050180Medicare PIN