Provider Demographics
NPI:1467430561
Name:MANSCHRECK, CHRIS EDWARD (DO)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:EDWARD
Last Name:MANSCHRECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 N 2ND ST
Mailing Address - Street 2:STE 205
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4657
Mailing Address - Country:US
Mailing Address - Phone:918-426-4560
Mailing Address - Fax:918-423-6326
Practice Address - Street 1:301 N 2ND ST
Practice Address - Street 2:STE 205
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4657
Practice Address - Country:US
Practice Address - Phone:918-426-4560
Practice Address - Fax:918-423-6326
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1955208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E09813Medicare UPIN