Provider Demographics
NPI:1396842951
Name:WYATT, CHRISTOPHER KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KEVIN
Last Name:WYATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:801 SUGARBUSH LN
Mailing Address - Street 2:
Mailing Address - City:BURKBURNETT
Mailing Address - State:TX
Mailing Address - Zip Code:76354-2538
Mailing Address - Country:US
Mailing Address - Phone:833-379-9288
Mailing Address - Fax:405-253-0577
Practice Address - Street 1:312 S AVENUE D
Practice Address - Street 2:
Practice Address - City:BURKBURNETT
Practice Address - State:TX
Practice Address - Zip Code:76354
Practice Address - Country:US
Practice Address - Phone:833-379-9288
Practice Address - Fax:405-253-0577
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4629982084P0800X
OK223012084P0800X
TXR5489208D00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice