Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 12979A | WY |
N | 207Q00000X | Family Doctor | 44394 | CO |
N | 207Q00000X | Family Doctor | L0959 | TX |
N | 207QS0010X | Family Doctor - Sports Medicine | 44394 | CO |
N | 207QS0010X | Family Doctor - Sports Medicine | L0959 | TX |
NPI | 1275524779 |
---|---|
Provider Name | Dr. Christopher Eric Williams |
First Address | Rawlins, WY 82301-0460 |
Second Address | Saratoga, WY 82331-5213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12979A | STATE LICENSE (01) | WY |
24377767 | (05) | CO |
H55867 | (02) | CO |