1134173032 NPI number — CHRISTOPHER LEE AMLING M.D., F.A.C.S.

Table of content: CHRISTOPHER LEE AMLING M.D., F.A.C.S. (NPI 1134173032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134173032 NPI number — CHRISTOPHER LEE AMLING M.D., F.A.C.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMLING
Provider First Name:
CHRISTOPHER
Provider Middle Name:
LEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D., F.A.C.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134173032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3303 SW BOND AVE, MAIL CODE CH10U
Provider Second Line Business Mailing Address:
OHSU, UROLOGY
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-418-9132
Provider Business Mailing Address Fax Number:
503-346-1501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3303 SW BOND AVE, MAIL CODE CH10U
Provider Second Line Business Practice Location Address:
OHSU, UROLOGY
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-418-9132
Provider Business Practice Location Address Fax Number:
503-346-1501
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  26881 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: MD29001 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009934508 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051530720 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 08335584 . This is a "MISSISSIPPI MEDICAID" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: P00253526 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: D73083 . This is a "VIVA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009933011 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009934507 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051530722 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 07026095 . This is a "MISSISSIPPI MEDICAID" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 051530721 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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