Healthcare Provider Details

I. General information

NPI: 1154943918
Provider Name (Legal Business Name): WILLIAMSON EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 ROBERTS DR STE J
NEW ROADS LA
70760-2661
US

IV. Provider business mailing address

550 CONNELL PARK LN
BATON ROUGE LA
70806-6539
US

V. Phone/Fax

Practice location:
  • Phone: 225-618-0088
  • Fax: 225-618-0055
Mailing address:
  • Phone: 225-924-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES HAMILTON WILLIAMSON
Title or Position: OWNER
Credential: MD
Phone: 225-715-1164