Christensen, Brent
Christensen, Brent is an sole proprietor health care provider with primary practice located at 1777 E Clark St Suite 220, Pocatello ID 83201-3357. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Christensen, Brent can be contacted via phone (208) 235-1777.Contact Information
Primary practice address
1777 E Clark St Suite 220
Pocatello ID 83201-3357
Phone: (208) 235-1777
Fax: (208) 232-7518
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | P-166 | Idaho |
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | P-166 | Idaho |
Profile Details
NPI number | 1487688990 |
---|---|
LBN Legal business name | Christensen, Brent |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 10th, 2006 |
Last updated | Jun 20th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1487688990 | NPPES |
Idaho | Other | 000010152768 | BLUE SHEILD |
Idaho | MEDICAID | 806402300 | BLUE SHEILD |
Idaho | Other | P-1985 | BLUE SHEILD |
Idaho | Other | 71-0943024 | BLUE SHEILD |
Idaho | Other | P00031188 | BLUE SHEILD |
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