Basic Information
Provider Information
NPI: 1801455225
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARTNER
FirstName: CHRISTOPHER
MiddleName: BURKE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 SOUTH JACKSON STREET, ACB 3RD FLOOR
Address2: UNIVERSITY OF LOUISVILLE
City: LOUISVILLE
State: KY
PostalCode: 402021702
CountryCode: US
TelephoneNumber: 5028525666
FaxNumber:  
Practice Location
Address1: 550 SOUTH JACKSON STREET, ACB 3RD FLOOR
Address2: UNIVERSITY OF LOUISVILLE
City: LOUISVILLE
State: KY
PostalCode: 402021702
CountryCode: US
TelephoneNumber: 5028525666
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/10/2019
LastUpdateDate: 03/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home