Basic Information
Provider Information
NPI: 1083000780
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARNER
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 699
Address2:  
City: MOUNTAIN HOME
State: TN
PostalCode: 376840699
CountryCode: US
TelephoneNumber: 4234336039
FaxNumber: 4234336060
Practice Location
Address1: 208 MEDICAL PARK BLVD
Address2:  
City: BRISTOL
State: TN
PostalCode: 37620
CountryCode: US
TelephoneNumber: 4239894050
FaxNumber: 4239903045
Other Information
ProviderEnumerationDate: 04/09/2015
LastUpdateDate: 08/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207Q00000XMD55224TNY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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