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General NPI Number Information
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NPI Number | 1366873424
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Entity Type | Individual
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Provider Name | PATRICIA WILLIAMSON
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Gender | Female
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 1210 HIGHWAY 31 NW SUITE CC
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City | HARTSELLE
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State | AL
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Zip | 35640-4465
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Country | US
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Telephone | 256-773-2840
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Fax |
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Provider Business Mailing Address
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Address Line | 2366 COUNTY ROAD 198
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City | DANVILLE
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State | AL
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Zip | 35619-9408
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Country | US
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Telephone | 256-462-1288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | AL3464
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License Number State | AL
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