Healthcare Provider Details

I. General information

NPI: 1316332448
Provider Name (Legal Business Name): CHRISTOPHER HOWARD FENZEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 BARDSTOWN RD
LOUISVILLE KY
40291-3207
US

IV. Provider business mailing address

2123 SPEED AVE
LOUISVILLE KY
40205-1332
US

V. Phone/Fax

Practice location:
  • Phone: 502-928-4700
  • Fax:
Mailing address:
  • Phone: 502-314-2767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01092044A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberW2416
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberTP447
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number76289
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number81361
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.177917
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35C.003548
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD493029C
License Number StatePA
# 9
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number52633
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: