MEDICARE: ROBERT T. WILLIAMSON, MD DBA INDIANA EYECARE CENTER

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

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	:	1740385293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT T. WILLIAMSON, MD DBA INDIANA EYECARE CENTER

Provider Business Mailing Address
First Line	:	1400 TEAL RD
Second Line	:	SUITE 8
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-2464
Country	:	US
Telephone Number	:	765-477-2020
Fax Number	:	765-477-8200

Provider Business Practice Location Address
First Line	:	1400 TEAL RD
Second Line	:	SUITE 8
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-2464
Country	:	US
Telephone Number	:	765-477-2020
Fax Number	:	765-477-8200

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT T WILLIAMSON
Credential	:	MD
Telephone Number	:	765-477-2020

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	06/17/2008

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