MEDICARE: ANTHONY 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
1	2084N0400X	Neurology Physician	10121	MT

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	:	1609829845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY WILLIAMSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1196
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59806-1196
Country	:	US
Telephone Number	:	406-360-9396
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 BAYLOR DR STE 155
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-8965
Country	:	US
Telephone Number	:	843-836-3667
Fax Number	:

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	01/06/2020

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Directions to “ ANTHONY WILLIAMSON M.D.” Practice Location

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