Provider Demographics
NPI:1477540292
Name:LYKINS, CHRISTOPHER L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:LYKINS
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 1:20201 N SCOTTSDALE HEALTHCARE DR
Mailing Address - Street 2:STE 230
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4134
Mailing Address - Country:US
Mailing Address - Phone:480-684-1360
Mailing Address - Fax:480-273-8695
Practice Address - Street 1:20201 N SCOTTSDALE HEALTHCARE DR
Practice Address - Street 2:STE 230
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4134
Practice Address - Country:US
Practice Address - Phone:480-684-1360
Practice Address - Fax:480-273-8695
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30482207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00452180OtherMEDICARE RAILROAD
AZ776859Medicaid
AZAZ0779400OtherBLUE CROSS BLUE SHIELD
H49827Medicare UPIN
AZP00452180OtherMEDICARE RAILROAD