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General NPI Number Information
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NPI Number | 1831177047
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Entity Type | Individual
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Provider Name | CHRISTIAN LUESSENHOP M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 1809 E 13TH ST STE 402
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City | TULSA
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State | OK
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Zip | 74104
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Country | US
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Telephone | 918-579-2300
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Fax | 918-579-2309
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Provider Business Mailing Address
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Address Line | 1809 E 13TH ST STE 402
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City | TULSA
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State | OK
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Zip | 74104-4431
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Country | US
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Telephone | 918-579-2300
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Fax | 918-579-2309
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 19557
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License Number State | OK
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