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NPI Code Detail

MEDICARE: DR. ALAN L CHRISTENSEN M.D.

MEDICARE: DR. ALAN L CHRISTENSEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician172326-1205UT
2207V00000XObstetrics & Gynecology Physician13746MS
3207V00000XObstetrics & Gynecology Physician41260KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
173823OTHERUTPEHP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
417232612000001OTHERUTBLUE CROSS BLUE SHIELD
5QM0000068942OTHERUTALTIUS

General Provider Information

NPI Number : 1194720250
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALAN L CHRISTENSEN M.D.
Provider Business Mailing Address
First Line : 1115 SE 164TH AVE DEPT 358
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-8004
Country : US
Telephone Number : 907-228-7688
Fax Number : 907-228-8468
Provider Business Practice Location Address
First Line : 3100 TONGASS AVE
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5746
Country : US
Telephone Number : 907-228-7688
Fax Number : 907-228-8468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/04/2016

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