Provider Demographics
NPI:1275524779
Name:WILLIAMS, CHRISTOPHER ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:WILLIAMS
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:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-0460
Mailing Address - Country:US
Mailing Address - Phone:307-324-2221
Mailing Address - Fax:307-326-3470
Practice Address - Street 1:1504 S RIVER ST
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:WY
Practice Address - Zip Code:82331-5213
Practice Address - Country:US
Practice Address - Phone:307-315-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY12979A207Q00000X
CO44394207Q00000X, 207QS0010X
TXL0959207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY12979AOtherSTATE LICENSE
CO24377767Medicaid
TXA002OtherCHAMPUS
TX080192621Medicare ID - Type UnspecifiedRR MEDICARE
TX151733601Medicaid
TX0064HXOtherBCBS
TX151733605Medicaid
TX8900B6Medicare ID - Type Unspecified