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General NPI Number Information
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NPI Number | 1083689327
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Entity Type | Organization
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Legal Business Name | COFFEYVILLE FAMILY PRACTICE CLINIC, P.A.
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 209 W 7TH ST
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City | COFFEYVILLE
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State | KS
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Zip | 67337-4903
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Country | US
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Telephone | 620-251-1100
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Fax | 620-251-7466
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Provider Business Mailing Address
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Address Line | PO BOX 564
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City | COFFEYVILLE
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State | KS
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Zip | 67337-0564
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Country | US
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Telephone | 620-251-1100
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Fax | 620-251-7466
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JAMES L. CHRISTENSEN
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Credential | D.O.
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Telephone | 620-251-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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