Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 7246 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | DMD-7246 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | MD-38014 | KY |
NPI | 1487646139 |
---|---|
Provider Name | Dr. Christopher C Babcock |
First Address | Louisville, KY 40202-1882 |
Second Address | Louisville, KY 40202-1882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 26/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000297067 | BCBS (01) | KY |
60072469 | (05) | KY |
64072812 | (05) | KY |
I01448 | (02) |