Individual
MR. CHRISTOPHER GREENHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
716 S HIGHWAY 77, NEWKIRK, OK 74647-7009
(580) 362-2555
(580) 362-2948
Mailing address
1201 E HARTFORD AVE, PONCA CITY, OK 74601-2018
(918) 642-3100
(918) 642-5639
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2378
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200530330A
—
OK
Enumeration date
01/30/2014
Last updated
09/25/2019
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