Healthcare Provider Details

I. General information

NPI: 1750708673
Provider Name (Legal Business Name): CHRISTOPHER ALFORD DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N6255 CHURCH RD
DELAVAN WI
53115-2440
US

IV. Provider business mailing address

N6255 CHURCH RD
DELAVAN WI
53115-2440
US

V. Phone/Fax

Practice location:
  • Phone: 608-883-2995
  • Fax: 608-883-6377
Mailing address:
  • Phone: 608-883-2995
  • Fax: 608-883-6377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6885
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number090.011111
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: