Provider Demographics
NPI:1033294533
Name:SHARPE, CHRISTOPHER ROBERT (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:SHARPE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8469 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39325
Mailing Address - Country:US
Mailing Address - Phone:601-626-7706
Mailing Address - Fax:
Practice Address - Street 1:1801 FULLER RD
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39309-5106
Practice Address - Country:US
Practice Address - Phone:601-679-3967
Practice Address - Fax:601-679-2973
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant