Provider Demographics
NPI:1265435135
Name:TIGHE, CHRISTOPHER J (DPM)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:TIGHE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 MAYFIELD RD
Mailing Address - Street 2:STE 103
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3037
Mailing Address - Country:US
Mailing Address - Phone:216-381-5000
Mailing Address - Fax:216-381-3339
Practice Address - Street 1:4225 MAYFIELD RD
Practice Address - Street 2:STE 103
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3037
Practice Address - Country:US
Practice Address - Phone:216-381-5000
Practice Address - Fax:216-381-3339
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
OH36002436T213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTI0609262Medicare ID - Type Unspecified
OHT80655Medicare UPIN