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NPI Code Detail

MEDICARE: CHRISTOPHER JAMES KALLINGER PA-C, MMS

MEDICARE: CHRISTOPHER JAMES KALLINGER PA-C, MMS
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
1363A00000XPhysician Assistant9110002FL

General Provider Information

NPI Number : 1720520687
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JAMES KALLINGER PA-C, MMS
Provider Business Mailing Address
First Line : 6650 CORPORATE CENTER PKWY
Second Line : APT 208
City : JACKSONVILLE
State : FL
Zip : 32216-0988
Country : US
Telephone Number : 321-356-7269
Fax Number :
Provider Business Practice Location Address
First Line : 1514 NIRA ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8652
Country : US
Telephone Number : 904-387-4991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2016
Last Update Date : 11/09/2016

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