Provider Demographics
NPI:1669637187
Name:CHRISTENSEN, GEORGE CLIFTON III (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CLIFTON
Last Name:CHRISTENSEN
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 636324
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6324
Mailing Address - Country:US
Mailing Address - Phone:859-301-9010
Mailing Address - Fax:859-301-9018
Practice Address - Street 1:711 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-301-9010
Practice Address - Fax:859-301-9018
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYTP565208G00000X
KY03878208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0124248Medicaid