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NPI Code Detail

MEDICARE: DR. ROBERT G WILLIAMSON M.D.

MEDICARE: DR. ROBERT G WILLIAMSON M.D.
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
12084P0800XPsychiatry PhysicianK5430TX
22084P0800XPsychiatry Physician37934AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316950298
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT G WILLIAMSON M.D.
Provider Business Mailing Address
First Line : 903 N 2ND ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1906
Country : US
Telephone Number : 602-416-7600
Fax Number : 602-416-7703
Provider Business Practice Location Address
First Line : 903 N 2ND ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1906
Country : US
Telephone Number : 602-416-7600
Fax Number : 602-416-7703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 06/08/2011

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