MEDICARE: DR. THOMAS B WILLIAMSON MD

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	207R00000X	Internal Medicine Physician	35-04-3844-W	OH

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

General Provider Information

NPI Number	:	1295774461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS B WILLIAMSON MD

Provider Business Mailing Address
First Line	:	1031 PIERCE STREET
Second Line	:	SUITE D
City	:	SANDUSKY
State	:	OH
Zip	:	44870
Country	:	US
Telephone Number	:	419-557-5541
Fax Number	:	419-557-5542

Provider Business Practice Location Address
First Line	:	300 WILLIAMS ST
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-1648
Country	:	US
Telephone Number	:	419-433-5222
Fax Number	:	419-433-8214

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	09/11/2012

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