Healthcare Provider Details

I. General information

NPI: 1538104823
Provider Name (Legal Business Name): CHRISTOPHER A LANDESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 BARTLETT ST
HOMER AK
99603-7000
US

IV. Provider business mailing address

4300 BARTLETT ST
HOMER AK
99603-7000
US

V. Phone/Fax

Practice location:
  • Phone: 907-235-8101
  • Fax: 888-892-2443
Mailing address:
  • Phone: 907-235-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number129238
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number31988
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: