=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164450045
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER KENT ECHTERLING MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2006
-----------------------------------------------------
Last Update Date | 06/13/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 605 S GEORGE ST SUITE 200
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17403-3160
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-851-2334
-----------------------------------------------------
Fax | 717-851-3498
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1803 MOUNT ROSE AVE SUITE B3
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17403-3026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-851-1405
-----------------------------------------------------
Fax | 717-851-3498
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD054045L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------