Provider Demographics
NPI:1811957665
Name:JAMES, CHRISTOPHER A (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:A
Last Name:JAMES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4415
Mailing Address - Country:US
Mailing Address - Phone:765-459-5137
Mailing Address - Fax:765-459-5138
Practice Address - Street 1:300 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4415
Practice Address - Country:US
Practice Address - Phone:765-459-5137
Practice Address - Fax:765-459-5138
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002884A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200139940Medicaid
IN452570005Medicare PIN
IN200139940Medicaid
IN410046412Medicare PIN
IN160450026Medicare PIN
IN410046413Medicare PIN
IN084190DMedicare PIN
IN367160GMedicare PIN