Provider Demographics
NPI:1174028716
Name:HARPER, CHRISTOPHER LYNN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LYNN
Last Name:HARPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1896 CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-3502
Mailing Address - Country:US
Mailing Address - Phone:918-853-6429
Mailing Address - Fax:
Practice Address - Street 1:200 ROCKRIDGE RD STE 110
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2751
Practice Address - Country:US
Practice Address - Phone:937-836-9921
Practice Address - Fax:937-836-1298
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.141844208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0468949Medicaid