Provider Demographics
NPI:1396879185
Name:CHRISTOPHER MD & ASSOCIATES, PA
Entity type:Organization
Organization Name:CHRISTOPHER MD & ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:INDUMATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-682-6320
Mailing Address - Street 1:131 E REDSTONE AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5326
Mailing Address - Country:US
Mailing Address - Phone:850-682-6320
Mailing Address - Fax:850-682-6339
Practice Address - Street 1:131 E REDSTONE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5326
Practice Address - Country:US
Practice Address - Phone:850-682-6320
Practice Address - Fax:850-682-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2012340OtherFIRST HEALTH NUMBER
FL274400700Medicaid
FL1431330005OtherCIGNA PROVIDER NUMBER
FL7689404OtherAETNA PROVIDER NUMBER
FL2236414005OtherUNITED HEALTHCARE NUMBER
FL31703OtherBCBS PROVIDER NUMBER
FL2012340OtherFIRST HEALTH NUMBER
FL2012340OtherFIRST HEALTH NUMBER