Individual
CHRISTOPHER LOUIS WIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 PERSIMMONS ST, BLUFFTON, SC 29910-4779
(912) 629-7800
(854) 235-2822
Mailing address
PO BOX 37643, BELFAST, ME 04915-1218
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
22196
SC
2086S0129X
Vascular Surgery Physician
049122
GA
2086S0129X
Vascular Surgery Physician
Primary
22196
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000880569B
—
GA
01
—
10065827
AMERIGROUP
GA
01
—
349840
WELLCARE OF GA
GA
05
—
G49122
—
SC
Enumeration date
06/23/2006
Last updated
02/04/2026
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