# CHRISTOPHER STARK MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659812014
- **Authorized official:** SAMUEL FORD CPC, CANPC (BILLING MANAGER)
- **Authorized official phone:** (859) 881-3139

## Contact information

- **Practice address:** 989 GOVERNORS LN, STE 180, LEXINGTON, KY 40513-1173
- **Practice address phone:** (859) 338-3958
- **Mailing address:** 989 GOVERNORS LN, STE 180, LEXINGTON, KY 40513-1173
- **Mailing address phone:** (859) 338-3958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 39876 | KY | Yes |

## Other

- **Enumeration date:** 03/17/2017
- **Last updated:** 03/17/2017