Provider Demographics
NPI:1255695029
Name:STALLING, CHRISTOPHER BENNETT (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BENNETT
Last Name:STALLING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S UNION AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4355
Mailing Address - Country:US
Mailing Address - Phone:330-596-6500
Mailing Address - Fax:
Practice Address - Street 1:1900 S UNION AVE STE 100
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4355
Practice Address - Country:US
Practice Address - Phone:330-596-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.069775207XS0114X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program