Provider Demographics
NPI:1871523951
Name:CHRISTENSEN, KAY LINFORD (MD)
Entity type:Individual
Prefix:DR
First Name:KAY
Middle Name:LINFORD
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 CANTERBURY WAY
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7971
Mailing Address - Country:US
Mailing Address - Phone:208-522-5299
Mailing Address - Fax:
Practice Address - Street 1:2775 CHANNING WAY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7510
Practice Address - Country:US
Practice Address - Phone:208-524-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM4619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1116126Medicare ID - Type Unspecified
IDC36922Medicare UPIN