Provider Demographics
NPI:1407835408
Name:RAINS, CHRISTOPHER KENDALL (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KENDALL
Last Name:RAINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 PASS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-4044
Mailing Address - Country:US
Mailing Address - Phone:228-388-1115
Mailing Address - Fax:228-388-1511
Practice Address - Street 1:2318 PASS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4044
Practice Address - Country:US
Practice Address - Phone:228-388-1115
Practice Address - Fax:228-388-1511
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS567152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00087012Medicaid
MS410000053Medicare ID - Type Unspecified
MST92099Medicare UPIN