Healthcare Provider Details

I. General information

NPI: 1457641557
Provider Name (Legal Business Name): CHRISTOPHER KHAMPHOUNE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 BUFFALO RD
NORTH CHILI NY
14514-1256
US

IV. Provider business mailing address

P.O. BOX 505
NORTH CHILI NY
14514-1256
US

V. Phone/Fax

Practice location:
  • Phone: 585-594-5995
  • Fax: 585-594-5425
Mailing address:
  • Phone: 585-594-5995
  • Fax: 585-594-5425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM-2536
License Number StateGU
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number272226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: