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 1:1993 ERRECART BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8334
Mailing Address - Country:US
Mailing Address - Phone:775-753-1049
Mailing Address - Fax:775-777-8494
Practice Address - Street 1:1993 ERRECART BLVD
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8334
Practice Address - Country:US
Practice Address - Phone:775-753-1049
Practice Address - Fax:775-777-8494
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY12979A207Q00000X
CO44394207Q00000X, 207QS0010X
TXL0959207Q00000X, 207QS0010X
NV25404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY12979AOtherSTATE LICENSE
CO24377767Medicaid
NV25404OtherSTATE LICENSE
TX080192621Medicare ID - Type UnspecifiedRR MEDICARE
TX151733601Medicaid
TX0064HXOtherBCBS
TX151733605Medicaid
TX8900B6Medicare ID - Type Unspecified