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General NPI Number Information
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NPI Number | 1538104823
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Entity Type | Individual
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Provider Name | CHRISTOPHER A LANDESS MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 851 LOCUST ST
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City | ROGERSVILLE
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State | TN
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Zip | 37857-2407
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Country | US
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Telephone | 423-921-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 143 SUN CHASE CT
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City | GRAY
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State | TN
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Zip | 37615-5502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 31988
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License Number State | TN
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