Provider Demographics
NPI:1164804159
Name:WHITTEN, CHRISTOPHER T (AUD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:T
Last Name:WHITTEN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 KENT RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4429
Mailing Address - Country:US
Mailing Address - Phone:440-376-5405
Mailing Address - Fax:330-688-2170
Practice Address - Street 1:3226 KENT RD STE 102
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4466
Practice Address - Country:US
Practice Address - Phone:440-376-5405
Practice Address - Fax:330-688-2190
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03034237700000X
OHA.01967237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH310710OtherMEDICARE