Provider Demographics
NPI:1093920670
Name:MCWILLIAMS, CHRISTI LB (LDO)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:LB
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COLLEGE RD STE 14
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-1739
Mailing Address - Country:US
Mailing Address - Phone:907-374-4454
Mailing Address - Fax:907-374-4443
Practice Address - Street 1:29 COLLEGE RD STE 14
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-1739
Practice Address - Country:US
Practice Address - Phone:907-374-4454
Practice Address - Fax:907-374-4443
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK248156FX1800X
AK248156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDOPD248OtherOCCUPATIONAL LICENSE