Provider Demographics
NPI:1043346893
Name:IKE, CHRISTOPHER O (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:O
Last Name:IKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6135
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-6135
Mailing Address - Country:US
Mailing Address - Phone:478-738-9443
Mailing Address - Fax:478-738-8797
Practice Address - Street 1:4300 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1306
Practice Address - Country:US
Practice Address - Phone:334-793-9564
Practice Address - Fax:334-340-2805
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2005-00555207R00000X, 207RC0000X
GA70218207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease