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General NPI Number Information
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NPI Number | 1972509156
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Entity Type | Organization
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Legal Business Name | WILLIAMSON EYE CENTER
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 5233 MAIN ST STE A
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City | ZACHARY
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State | LA
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Zip | 70791-3978
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Country | US
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Telephone | 225-654-0090
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Fax | 225-654-8044
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Provider Business Mailing Address
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Address Line | 5233 MAIN ST STE A
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City | ZACHARY
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State | LA
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Zip | 70791-3978
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Country | US
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Telephone | 225-654-0090
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Fax | 225-654-8044
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Authorized Official
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Title or Position | MD, MEDICAL DIRECTOR, OWNER
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Name | DR. CHARLES HAMILTON WILLIAMSON
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Credential | MD
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Telephone | 225-924-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4458
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4458
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License Number State | LA
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