Provider Demographics
NPI:1376949313
Name:FRANZ, CHRISTOPHER T (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:T
Last Name:FRANZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:T
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 636324
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6324
Mailing Address - Country:US
Mailing Address - Phone:859-301-2465
Mailing Address - Fax:859-301-4941
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:859-301-2465
Practice Address - Fax:859-301-4941
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2080363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0119838Medicaid
OHH457090Medicare PIN