MEDICARE: CHRISTINE VILLEGAS M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208D00000X	General Practice Physician	307474	NY

General Provider Information

NPI Number	:	1083140925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE VILLEGAS M.D.

Provider Business Mailing Address
First Line	:	3700 S RAILROAD ST STE A
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2994
Country	:	US
Telephone Number	:	334-664-0463
Fax Number	:	334-408-6354

Provider Business Practice Location Address
First Line	:	3700 S RAILROAD ST STE A
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2994
Country	:	US
Telephone Number	:	334-664-0463
Fax Number	:	334-408-6354

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	07/16/2025

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