Provider Demographics
NPI:1245227784
Name:HENDRIX, CHRISTOPHER L (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-3904
Mailing Address - Country:US
Mailing Address - Phone:901-207-5176
Mailing Address - Fax:901-201-5125
Practice Address - Street 1:7400 US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-3904
Practice Address - Country:US
Practice Address - Phone:901-207-5176
Practice Address - Fax:901-201-5125
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN519213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3352830Medicaid
TNU71691Medicare UPIN
TN3352830Medicaid