MEDICARE: DR. CHRISTOPHER L WILLINGHAM 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	207W00000X	Ophthalmology Physician	ME90865	FL

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	:	1225096183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER L WILLINGHAM M.D.

Provider Business Mailing Address
First Line	:	2439 CARE DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4580
Country	:	US
Telephone Number	:	850-942-6700
Fax Number	:	850-942-5735

Provider Business Practice Location Address
First Line	:	2577 HUNTCLIFF LN
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4902
Country	:	US
Telephone Number	:	850-763-7007
Fax Number	:	850-763-7002

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	03/11/2015

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