Healthcare Provider Details

I. General information

NPI: 1669114716
Provider Name (Legal Business Name): CHRISTIAN ALEXANDER GIVENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5953 ELEMENTARY WAY STE 109
COLLEGE DALE TN
37363-3172
US

IV. Provider business mailing address

5953 ELEMENTARY WAY STE 109
COLLEGE DALE TN
37363-3172
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-9174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number73675
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: