Doctor Name: | MR. JOHN MICHAEL WILLIAMSON |
NPI Number: | 1336326560 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-C,CEN |
License Number: | R853568 |
Business Practice Address: | 655 7th St Bldg 700 Robins Afb, GA - 310982227 |
Business Phone Number: | 4783277793 |
Business Fax Number: | |
Mailing Address: | 655 7th St, Bldg 700 ROBINS AFB |
State: | GA |
Postal Code: | 310982227 |
Phone Number: | 4783277793 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2008 |
NPI Last Update Date: | 12/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R853568 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |