Provider Demographics
NPI:1881693752
Name:SCHULTZ, CRISTOPHER D (DO)
Entity type:Individual
Prefix:
First Name:CRISTOPHER
Middle Name:D
Last Name:SCHULTZ
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5714
Mailing Address - Country:US
Mailing Address - Phone:580-747-6359
Mailing Address - Fax:
Practice Address - Street 1:330 E CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5714
Practice Address - Country:US
Practice Address - Phone:580-249-3904
Practice Address - Fax:580-234-3031
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4031207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP01089401OtherRR MEDICARE
OK200051450AMedicaid
OKOKA105871Medicare PIN