Provider Demographics
NPI:1821083106
Name:STARNES, CHRITSOPHER T (MD)
Entity Type:Individual
Prefix:
First Name:CHRITSOPHER
Middle Name:T
Last Name:STARNES
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 1:5542 BURWELL RD
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-5929
Mailing Address - Country:US
Mailing Address - Phone:276-365-8071
Mailing Address - Fax:276-221-1529
Practice Address - Street 1:143 WOODLAND DR SW
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-4623
Practice Address - Country:US
Practice Address - Phone:276-365-8071
Practice Address - Fax:276-221-1529
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39257207R00000X
VA0101237492207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64102858Medicaid
VA190001321Medicaid
I33237Medicare UPIN
VA010176620Medicare PIN
KY64102858Medicaid