Provider Demographics
NPI:1225800089
Name:PATE, CHRISTOPHER LATON (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LATON
Last Name:PATE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 BEAVERDAM RD
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2652
Mailing Address - Country:US
Mailing Address - Phone:808-673-1987
Mailing Address - Fax:
Practice Address - Street 1:1880 FALL RIVER DR STE 250
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7158
Practice Address - Country:US
Practice Address - Phone:970-775-8626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COP.A.0008428363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant