Provider Demographics
NPI:1053563155
Name:CHRISTIAN J. YORK, M.D., P.C.
Entity type:Organization
Organization Name:CHRISTIAN J. YORK, M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-327-2229
Mailing Address - Street 1:4194 ROYAL PINE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1507
Mailing Address - Country:US
Mailing Address - Phone:719-327-2229
Mailing Address - Fax:719-282-2983
Practice Address - Street 1:4194 ROYAL PINE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1507
Practice Address - Country:US
Practice Address - Phone:719-327-2229
Practice Address - Fax:719-282-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43070207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61956759Medicaid
CO61956759Medicaid