MEDICARE: DR. CHRISTOPHER J ADDISON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO1486	FL

General Provider Information

NPI Number	:	1528060407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER J ADDISON DPM

Provider Business Mailing Address
First Line	:	1800 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1335
Country	:	US
Telephone Number	:	941-758-8818
Fax Number	:	941-755-2901

Provider Business Practice Location Address
First Line	:	1800 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1335
Country	:	US
Telephone Number	:	941-758-8818
Fax Number	:	941-755-2901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	01/03/2020

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