Provider Demographics
NPI:1144402389
Name:ALEXANDER, CHRISTOPHER WAYNE (CPO, BOCPO, CPED)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:CPO, BOCPO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 E STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-7115
Mailing Address - Country:US
Mailing Address - Phone:423-288-8559
Mailing Address - Fax:423-288-5227
Practice Address - Street 1:3551 E STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-7115
Practice Address - Country:US
Practice Address - Phone:423-288-8559
Practice Address - Fax:423-288-5227
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
C19995222Z00000X
TNPRO0000000075224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist