Provider Demographics
NPI:1225096183
Name:WILLINGHAM, CHRISTOPHER L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:WILLINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2439 CARE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4580
Mailing Address - Country:US
Mailing Address - Phone:850-942-6700
Mailing Address - Fax:850-942-5735
Practice Address - Street 1:2577 HUNTCLIFF LN
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4902
Practice Address - Country:US
Practice Address - Phone:850-763-7007
Practice Address - Fax:850-763-7002
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME90865207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270088300Medicaid
FL270088300Medicaid
FL48098YMedicare PIN