| Doctor Name: | WALLACE FRANKLIN WILLIAMSON |
| NPI Number: | 1912044546 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME13865 |
| Business Practice Address: | 2659 W Oakland Park Blvd # 2679 Oakland Park, FL - 333111355 |
| Business Phone Number: | 9547339000 |
| Business Fax Number: | 9547334366 |
| Mailing Address: | 5741 Sw 5th St, PLANTATION |
| State: | FL |
| Postal Code: | 333173531 |
| Phone Number: | 9547339000 |
| Fax Number: | 9547334366 |
| NPI Enumeration Date: | 01/31/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | ME13865 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |