Provider Demographics
NPI:1881815074
Name:WALDROP, CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:WALDROP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ENTERPRISE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2762
Mailing Address - Country:US
Mailing Address - Phone:662-638-6377
Mailing Address - Fax:
Practice Address - Street 1:300 ENTERPRISE DR
Practice Address - Street 2:SUITE B
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-2762
Practice Address - Country:US
Practice Address - Phone:662-638-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20317207L00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology