MEDICARE: DR. BLAKE DALBERT CHRISTENSEN D.O.

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	207L00000X	Anesthesiology Physician	036.135761	IL
2	207L00000X	Anesthesiology Physician	4887	OK
3	208VP0014X	Interventional Pain Medicine Physician	4887	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841425477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLAKE DALBERT CHRISTENSEN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 514
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73070-0514
Country	:	US
Telephone Number	:	405-751-0011
Fax Number	:	405-751-7246

Provider Business Practice Location Address
First Line	:	14000 N PORTLAND AVE STE 101
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-4004
Country	:	US
Telephone Number	:	405-751-0011
Fax Number	:	405-751-7246

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

Provider Enumeration Date	:	05/27/2009
Last Update Date	:	12/20/2021

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