Provider Demographics
NPI:1891862082
Name:LAVERS, CHRIS D (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:D
Last Name:LAVERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SE FRANK PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003
Mailing Address - Country:US
Mailing Address - Phone:918-214-8888
Mailing Address - Fax:918-214-8887
Practice Address - Street 1:309 SE FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003
Practice Address - Country:US
Practice Address - Phone:918-214-8888
Practice Address - Fax:918-214-8887
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004030997363AM0700X
OK1214207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK20003030AMedicaid
OK200033030AMedicaid
OKP00193731OtherMC RAILROAD
OK200033030AMedicaid
OKP00193731OtherMC RAILROAD