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General NPI Number Information
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NPI Number | 1245406495
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER KOLKER, MD PLLC
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 816 FRISCO AVE STE A
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City | CLINTON
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State | OK
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Zip | 73601-3701
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Country | US
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Telephone | 580-323-4644
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Fax | 580-323-1620
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Provider Business Mailing Address
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Address Line | 816 FRISCO AVE STE A
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City | CLINTON
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State | OK
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Zip | 73601-3701
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Country | US
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Telephone | 580-323-4644
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Fax | 580-323-1620
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | CHRISTOPHER KOLKER
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Credential | M.D.
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Telephone | 580-323-4644
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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 | 20223
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License Number State | OK
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