Provider Demographics
NPI:1275752552
Name:FINNELL, CHRISTOPHER WALLACE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WALLACE
Last Name:FINNELL
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 1:2945 SOUTHWEST PKWY
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-4145
Mailing Address - Country:US
Mailing Address - Phone:940-687-8000
Mailing Address - Fax:940-687-7005
Practice Address - Street 1:2945 SOUTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-4145
Practice Address - Country:US
Practice Address - Phone:940-687-8000
Practice Address - Fax:940-687-7005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4779208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K6398Medicare PIN
TX613270Medicare PIN