Provider Demographics
NPI:1679669212
Name:DOERR, CHRISTOPHER E (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:DOERR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MILES ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-1820
Mailing Address - Country:US
Mailing Address - Phone:706-546-1333
Mailing Address - Fax:706-546-5807
Practice Address - Street 1:195 MILES ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-1820
Practice Address - Country:US
Practice Address - Phone:706-546-1333
Practice Address - Fax:706-546-5807
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034578208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00463504FMedicaid
GA034578OtherPHYSICIAN LICENSE
BD0985828OtherDEA
GA00463504FMedicaid
E21221Medicare UPIN