Organization
BRIAN W CHRISTENSEN M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN W CHRISTENSEN M.D., PA (SURGEON)
(208) 656-9008
Entity
Organization
Contact information
Practice address
20 MADISON PROFESSIONAL PARK, REXBURG, ID 83440-2058
(208) 656-9008
(208) 656-0999
Mailing address
20 MADISON PROFESSIONAL PARK, REXBURG, ID 83440-2058
(208) 656-9008
(208) 656-0999
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7414
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004529
BLUE SHIELD
ID
05
—
805130600
—
ID
01
—
DT307
BLUE CROSS
ID
Enumeration date
09/24/2008
Last updated
10/27/2008
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