Provider Demographics
NPI:1043228141
Name:KING, CHRISTOPHER (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 DELAFIELD ST STE 105
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3402
Mailing Address - Country:US
Mailing Address - Phone:262-542-9503
Mailing Address - Fax:262-542-8447
Practice Address - Street 1:1111 DELAFIELD ST STE 105
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3402
Practice Address - Country:US
Practice Address - Phone:262-542-9503
Practice Address - Fax:262-542-8447
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33081-021207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIF338801Medicare UPIN