Healthcare Provider Details

I. General information

NPI: 1033205315
Provider Name (Legal Business Name): JAMES SCOTT WILLIAMSON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 E COURT ST PARIS COMMUNITY HOSPITAL
PARIS IL
61944
US

IV. Provider business mailing address

525 PRAIRIE ST
PARIS IL
61944-1433
US

V. Phone/Fax

Practice location:
  • Phone: 217-465-4141
  • Fax:
Mailing address:
  • Phone: 217-265-3146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR858455
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209.007081
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: