Provider Demographics
NPI:1891775276
Name:CHRISTENSEN, DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 ROBINS SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ROBINS
Mailing Address - State:IA
Mailing Address - Zip Code:52328
Mailing Address - Country:US
Mailing Address - Phone:319-377-2222
Mailing Address - Fax:319-294-4299
Practice Address - Street 1:1065 EAST POST RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302
Practice Address - Country:US
Practice Address - Phone:319-377-2222
Practice Address - Fax:319-377-2967
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02182152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA21637OtherBC/BS
IA28986OtherBC/BS
410043671OtherRR MEDICARE
IA0461921Medicaid
7236139OtherAETNA
IA21634OtherBC/BS
IA0260340001Medicare NSC
IA21634OtherBC/BS
IA0260340003Medicare NSC
IA28986OtherBC/BS
U81509Medicare UPIN
I0171Medicare ID - Type Unspecified