Healthcare Provider Details

I. General information

NPI: 1427252519
Provider Name (Legal Business Name): STEPHEN ERIC WILLIAMSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 RAYMOND ST
ORLANDO FL
32803-8208
US

IV. Provider business mailing address

6822 W RIVERCHASE DR
TEMPLE TERRACE FL
33637-5663
US

V. Phone/Fax

Practice location:
  • Phone: 321-397-6601
  • Fax:
Mailing address:
  • Phone: 813-943-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberC-6690
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: