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NPI Code Detail

MEDICARE: DR. BRET MICHAEL WILLIAMSON

MEDICARE: DR. BRET MICHAEL WILLIAMSON
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
11223G0001XGeneral Practice Dentistry61448KS

General Provider Information

NPI Number : 1962928531
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRET MICHAEL WILLIAMSON
Provider Business Mailing Address
First Line : 2794 E 45TH CT N
Second Line :
City : WICHITA
State : KS
Zip : 67219-2020
Country : US
Telephone Number : 620-694-9286
Fax Number :
Provider Business Practice Location Address
First Line : 2838 N OLIVER ST
Second Line :
City : WICHITA
State : KS
Zip : 67220-2983
Country : US
Telephone Number : 620-694-9286
Fax Number : 620-694-9286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2017
Last Update Date : 08/16/2017

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Directions to “ DR. BRET MICHAEL WILLIAMSON ” Practice Location

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