Provider Demographics
NPI:1205834959
Name:SCHAFFER, CHRISTOPHER JON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JON
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 VILLAGE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6436
Mailing Address - Country:US
Mailing Address - Phone:205-980-1744
Mailing Address - Fax:205-980-1334
Practice Address - Street 1:140 VILLAGE ST STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6436
Practice Address - Country:US
Practice Address - Phone:205-980-1744
Practice Address - Fax:205-980-1334
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22158208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262572500Medicaid
E5072XMedicare ID - Type Unspecified
FL262572500Medicaid