Provider Demographics
NPI:1013247741
Name:JOHN R. CHRISTIANSEN INC MD
Entity Type:Organization
Organization Name:JOHN R. CHRISTIANSEN INC MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-329-4411
Mailing Address - Street 1:500 E ROBINSON ST
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6673
Mailing Address - Country:US
Mailing Address - Phone:405-329-4411
Mailing Address - Fax:405-329-4415
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:SUITE 1700
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-329-4411
Practice Address - Fax:405-329-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8872207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100195790AMedicaid
OKD34501Medicare UPIN