| Doctor Name: | CHRISTOPHER SC BLAISDELL |
| NPI Number: | 1013212331 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 5139 |
| Business Practice Address: | 635 W 11th St Osu Medical Center - Department Of Internal Medicine Tulsa, OK - 74127 |
| Business Phone Number: | 9183823535 |
| Business Fax Number: | |
| Mailing Address: | 1611 S Utica Ave # 229, TULSA |
| State: | OK |
| Postal Code: | 741044909 |
| Phone Number: | 6175127201 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2011 |
| NPI Last Update Date: | 07/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |