Healthcare Provider Details

I. General information

NPI: 1326481268
Provider Name (Legal Business Name): JOHN CHRISTOPHER MICHAEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BLANCA AVE
ALAMOSA CO
81101-2340
US

IV. Provider business mailing address

3117 SEAFOAM DR
CORPUS CHRISTI TX
78418-3912
US

V. Phone/Fax

Practice location:
  • Phone: 719-589-2511
  • Fax:
Mailing address:
  • Phone: 361-688-3979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04-46182
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDR.0058355
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: