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Organization
COFFEYVILLE FAMILY PRACTICE CLINIC, P.A.
Active
Organization
COFFEYVILLE FAMILY PRACTICE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES L. CHRISTENSEN D.O. (DOCTOR)
(620) 251-1100
Entity
Organization
Contact information
Practice address
209 W 7TH ST, COFFEYVILLE, KS 67337-4903
(620) 251-1100
(620) 251-7466
Mailing address
PO BOX 564, COFFEYVILLE, KS 67337-0564
(620) 251-1100
(620) 251-7466
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009974
BLUE CROSS BLUE SHIELD
KS
05
—
100098700A
—
KS
01
—
100722460A
OKLAHOMA MEDICAID
OK
Enumeration date
02/21/2006
Last updated
06/06/2013
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