Provider Demographics
NPI:1093829970
Name:THORNTON, CHRISTOPHER O (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:O
Last Name:THORNTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-7200
Mailing Address - Fax:314-747-4189
Practice Address - Street 1:510 S KINGSHIGHWAY BLVD
Practice Address - Street 2:DEPT RADIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1016
Practice Address - Country:US
Practice Address - Phone:314-362-7200
Practice Address - Fax:314-747-4189
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1121082085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209990217Medicaid
128540OtherBLUE CHOICE
13259OtherHCARE USA
209990217OtherMO CAID
P00053303OtherRR CARE
009013128OtherMO CARE
1390OtherMO BLUE
300095838OtherRR CARE
2781OtherGHP
009013128OtherCARE
032012444OtherCARE
1601275OtherPH PLAN
419076OtherH LINK
431725842MIDOtherMERCY
300095838OtherRR CARE
G76218Medicare UPIN