Provider Demographics
NPI:1770575656
Name:BIXLER, CHRISTOPHER JON (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JON
Last Name:BIXLER
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 1:11215 METRO PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1206
Mailing Address - Country:US
Mailing Address - Phone:239-208-2212
Mailing Address - Fax:
Practice Address - Street 1:11215 METRO PKWY STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1206
Practice Address - Country:US
Practice Address - Phone:239-208-2212
Practice Address - Fax:239-208-3994
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4717482084N0400X
WI513472084N0400X
MI43010695472084N0400X
WAMD000342152084N0400X
MT809192084N0400X
NH201912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI130E26028OtherBLUE CROSS BLUE SHIELD MI
NH3122148Medicaid
MI3514642Medicaid
MI4305370Medicaid
WIAPPRMedicaid
MI4458978Medicaid
MI4458978Medicaid