Provider Demographics
NPI:1578126231
Name:KLEIN, CHRISTOPHER BRADLEY (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRADLEY
Last Name:KLEIN
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 1:14 GREAT PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:ARAPAHOE
Mailing Address - State:WY
Mailing Address - Zip Code:82510-9144
Mailing Address - Country:US
Mailing Address - Phone:307-856-9281
Mailing Address - Fax:
Practice Address - Street 1:14 GREAT PLAINS RD
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:WY
Practice Address - Zip Code:82510-9144
Practice Address - Country:US
Practice Address - Phone:307-856-9281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY14910A207Q00000X, 207Q00000X
CODR.0065118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine