Healthcare Provider Details

I. General information

NPI: 1962751750
Provider Name (Legal Business Name): CHRISTOPHER T JAMES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12818 TESSON FERRY RD STE 205
SAINT LOUIS MO
63128-2945
US

IV. Provider business mailing address

36 HAMPTON VILLAGE PLZ
SAINT LOUIS MO
63109-2127
US

V. Phone/Fax

Practice location:
  • Phone: 314-843-9977
  • Fax:
Mailing address:
  • Phone: 314-481-6005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2008010326
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: