Provider Demographics
NPI:1881645851
Name:BOXELL, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:BOXELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9001 S 101ST E AVE
Mailing Address - Street 2:SUITE 190
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133
Mailing Address - Country:US
Mailing Address - Phone:918-392-9670
Mailing Address - Fax:918-392-9680
Practice Address - Street 1:9001 S 101ST E AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133
Practice Address - Country:US
Practice Address - Phone:918-392-9670
Practice Address - Fax:918-392-9680
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2011-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK18307207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100138620AMedicaid
OKC78907Medicare UPIN
OK100138620AMedicaid