Provider Demographics
NPI:1609815943
Name:ROSKO, CHRISTOPHER J (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:ROSKO
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 1:3909 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-2838
Mailing Address - Country:US
Mailing Address - Phone:205-330-1707
Mailing Address - Fax:205-333-0782
Practice Address - Street 1:2252 OLD TYLER RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-1700
Practice Address - Country:US
Practice Address - Phone:205-585-7420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.10560207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL105807Medicaid
AL515-93966OtherBCBS
AL1609815943OtherTRICARE SOUTH
AL051541357Medicaid
AL009985515Medicaid
AL515-41357OtherBCBS
AL515-93966OtherBCBS
AL930015628Medicare PIN
ALC70362Medicare UPIN
AL510I930423Medicare PIN
AL515-41357OtherBCBS