Basic Information
Provider Information | |||||||||
NPI: | 1205887510 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PRICE | ||||||||
FirstName: | CHRISTOPHER | ||||||||
MiddleName: | E | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2700 W NORFOLK AVE | ||||||||
Address2: |   | ||||||||
City: | NORFOLK | ||||||||
State: | NE | ||||||||
PostalCode: | 687014438 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4026447556 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 110 N 29TH ST | ||||||||
Address2: | SUITE 201 | ||||||||
City: | NORFOLK | ||||||||
State: | NE | ||||||||
PostalCode: | 687014424 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4028448121 | ||||||||
FaxNumber: | 4028448122 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/12/2006 | ||||||||
LastUpdateDate: | 03/12/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 21621 | NE | Y |   | Allopathic & Osteopathic Physicians | Anesthesiology |   |
No ID Information.