Healthcare Provider Details

I. General information

NPI: 1447559729
Provider Name (Legal Business Name): CHRISTOPHER JAMES KIEFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BROWN BADGETT LOOP
MADISONVILLE KY
42431-6176
US

IV. Provider business mailing address

536 FATE LUTZ RD
NEW BRIGHTON KY
42413
US

V. Phone/Fax

Practice location:
  • Phone: 270-824-7048
  • Fax:
Mailing address:
  • Phone: 612-991-0889
  • Fax: 612-605-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number01075296A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number49127
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: