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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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