MEDICARE: WILLIAM P WILLIAMSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC2824	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	DC2824	OTHER	TX	CHIROPRACTIC
3	601076	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1265437933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM P WILLIAMSON DC

Provider Business Mailing Address
First Line	:	145 CURTIS ST
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-4505
Country	:	US
Telephone Number	:	409-384-5763
Fax Number	:	409-384-1590

Provider Business Practice Location Address
First Line	:	145 CURTIS ST
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-4505
Country	:	US
Telephone Number	:	409-384-5763
Fax Number	:	409-384-1590

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/17/2008

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Directions to “ WILLIAM P WILLIAMSON DC” Practice Location

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