Provider Demographics
NPI:1932111325
Name:BEHR, CHRISTOPHER LYELL (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LYELL
Last Name:BEHR
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 1:835 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-9320
Mailing Address - Country:US
Mailing Address - Phone:662-495-2300
Mailing Address - Fax:662-495-2361
Practice Address - Street 1:835 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-9320
Practice Address - Country:US
Practice Address - Phone:662-495-2300
Practice Address - Fax:662-495-2361
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS09939207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSMS09939Medicaid
C69939Medicare UPIN
MS930002407Medicare ID - Type UnspecifiedER PHY #