Individual
JOHN SEVERIN KRISTOFERSON
Active
Individual
JOHN SEVERIN KRISTOFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F6842
TX
207X00000X
Orthopaedic Surgery Physician
TXF6842
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020KD
BCBS
TX
01
—
0474740001
MEDICARE SUPPLIER NUMBER
TX
01
—
200002820
PALMETTO GBA
TX
01
—
8J2030
BCBS
TX
Enumeration date
09/15/2005
Last updated
08/20/2018
Update your record
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