Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 010132053 | VA |
NPI | 1013982131 |
---|---|
Provider Name | Dr. John A Williamson |
First Address | Norfolk, VA 23507-1904 |
Second Address | Norfolk, VA 23507-1904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 10/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006408753 | (05) | VA |
B07176 | (02) |