Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 6185 | CO |
Y | 111NS0005X | Chiropractic Sports Physician | CH 9799 | FL |
NPI | 1306022397 |
---|---|
Provider Name | Dr. Christopher James Ourganian |
First Address | Naples, FL 34110-1439 |
Second Address | Naples, FL 34110-1439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2008 |
Last Update Date | 25/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004447700 | (05) | FL |
220JV | BCBS (01) | FL |
8414076 | AETNA HMO PIN (01) | FL |
8673713 | CIGNA ID (01) | FL |
9276183 | AETNA PIN (01) | FL |
FX850Z | MEDICARE (01) | FL |
K0166 | MEDICARE GROUP ID (01) | FL |