Provider Demographics
NPI:1295709871
Name:STEIDLE, CHRISTOPHER P (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:P
Last Name:STEIDLE
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:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-1325
Mailing Address - Country:US
Mailing Address - Phone:606-526-8131
Mailing Address - Fax:606-528-8661
Practice Address - Street 1:60 BRYAN BLVD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701
Practice Address - Country:US
Practice Address - Phone:606-528-1172
Practice Address - Fax:606-528-7169
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034402A208800000X
KY44889208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0748972Medicaid
IN000000087510OtherANTHEM BC/BS
KY7100190630Medicaid
OH0805598Medicaid
IN100329780Medicaid
IN10081380Medicaid
OH9928923Medicare PIN
IND95426Medicare UPIN
IN10081380Medicaid
OHDG2339Medicare PIN
IN136140HMedicare PIN
OH0748972Medicaid
INCB9217Medicare PIN