Provider Demographics
NPI:1649202516
Name:JAMES, CHRISTOPHER TODD (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TODD
Last Name:JAMES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRIST
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 504438
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:405-751-4664
Mailing Address - Fax:405-749-4561
Practice Address - Street 1:1919 E. MEMORIAL RD
Practice Address - Street 2:C/O MERCY AFTER HOURS
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-1253
Practice Address - Country:US
Practice Address - Phone:405-751-4664
Practice Address - Fax:405-749-4561
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1231363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200069660AMedicaid
OKP00632792Medicare PIN
OK242717901Medicare PIN
OK243627902Medicare PIN
OKQ35801Medicare UPIN