Provider Demographics
NPI:1841780418
Name:SMITH, CHRISTOPHER WILLIAMS (DO)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WILLIAMS
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ELDON PARKS DR STE A
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2459
Mailing Address - Country:US
Mailing Address - Phone:336-835-2349
Mailing Address - Fax:
Practice Address - Street 1:101 ELDON PARKS DR STE A
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2459
Practice Address - Country:US
Practice Address - Phone:336-835-2349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-01869208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery