Healthcare Provider Details

I. General information

NPI: 1366700361
Provider Name (Legal Business Name): CHRISTOPHER F. VILLAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N 9TH AVE STE 302
PENSACOLA FL
32504
US

IV. Provider business mailing address

OSF ST FRANCIS MEDICAL CTR 530 NE GLEN OAK AVENUE
PEORIA IL
61637-0001
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-2250
  • Fax: 850-416-2536
Mailing address:
  • Phone: 309-655-2642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME136542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: