Healthcare Provider Details

I. General information

NPI: 1669654802
Provider Name (Legal Business Name): CHRISTOPHER KEVIN OROS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 N. BEAVER STREET FMC HOSPITALIST PROGRAM
FLAGSTAFF AZ
86001-3118
US

IV. Provider business mailing address

PO BOX 29434
PHENIX AZ
85038-0365
US

V. Phone/Fax

Practice location:
  • Phone: 610-278-2000
  • Fax:
Mailing address:
  • Phone: 610-278-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT010785
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number005369
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: