MEDICARE: WILLIAMSON EYE CENTER

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	332H00000X	Eyewear Supplier
2	152WC0802X	Corneal and Contact Management Optometrist
3	363A00000X	Physician Assistant
4	152W00000X	Optometrist	4458	LA
5	207W00000X	Ophthalmology Physician	4458	LA

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	:	1972509156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMSON EYE CENTER

Provider Business Mailing Address
First Line	:	5233 MAIN ST
Second Line	:	STE A
City	:	ZACHARY
State	:	LA
Zip	:	70791-3978
Country	:	US
Telephone Number	:	225-654-0090
Fax Number	:	225-654-8044

Provider Business Practice Location Address
First Line	:	5233 MAIN ST
Second Line	:	STE A
City	:	ZACHARY
State	:	LA
Zip	:	70791-3978
Country	:	US
Telephone Number	:	225-654-0090
Fax Number	:	225-654-8044

Authorized Official
Title or Position	:	MD, MEDICAL DIRECTOR, OWNER
Name	:	DR. CHARLES HAMILTON WILLIAMSON
Credential	:	MD
Telephone Number	:	225-924-2020

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	08/12/2010

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Directions to “WILLIAMSON EYE CENTER ” Practice Location

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