MEDICARE: DR. CAITLIN WILLIAMSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD2024-1190	NM
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207Q00000X	Family Medicine Physician	MD198119	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265893192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAITLIN WILLIAMSON MD

Provider Business Mailing Address
First Line	:	PO BOX 26666
Second Line	:	PHS PROVIDER ENROLLMENT
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-6666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4588 PARADISE BLVD NW
Second Line	:	VIRTUAL PRIMARY CARE
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-4105
Country	:	US
Telephone Number	:	505-923-2070
Fax Number	:	505-998-1710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2016
Last Update Date	:	01/28/2025

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Directions to “ DR. CAITLIN WILLIAMSON MD” Practice Location

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