Provider Demographics
NPI:1750816369
Name:KOEHN, CHRISTOPHER LEE (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:KOEHN
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 1:600 NE ADAMS DAIRY PKWY
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-5493
Mailing Address - Country:US
Mailing Address - Phone:816-251-6100
Mailing Address - Fax:816-347-4695
Practice Address - Street 1:600 NE ADAMS DAIRY PKWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-5493
Practice Address - Country:US
Practice Address - Phone:816-251-6100
Practice Address - Fax:816-347-4695
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2020021222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program