Healthcare Provider Details

I. General information

NPI: 1275732406
Provider Name (Legal Business Name): CHRISTOPHER ESPINOZA-ERVIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 BROADWAY EXT
OKLAHOMA CITY OK
73114-7408
US

IV. Provider business mailing address

9600 BROADWAY EXT
OKLAHOMA CITY OK
73114-7408
US

V. Phone/Fax

Practice location:
  • Phone: 405-230-9000
  • Fax: 405-230-9470
Mailing address:
  • Phone: 405-230-9000
  • Fax: 405-230-9470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number30200
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: