Provider Demographics
NPI:1376876631
Name:CHRISTENSEN, JOSEPH RUDI (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RUDI
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5053 EXECUTIVE DR
Mailing Address - Street 2:STE A
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2506
Mailing Address - Country:US
Mailing Address - Phone:252-633-0651
Mailing Address - Fax:252-514-9419
Practice Address - Street 1:3005 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5211
Practice Address - Country:US
Practice Address - Phone:252-633-0651
Practice Address - Fax:252-514-9419
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2145152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist