Provider Demographics
NPI:1073836755
Name:WILLIAMSON, JOSEPH ASBURY JR
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ASBURY
Last Name:WILLIAMSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29113-0310
Mailing Address - Country:US
Mailing Address - Phone:803-263-4795
Mailing Address - Fax:803-263-4809
Practice Address - Street 1:8412 SAVANNAH HWY
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:SC
Practice Address - Zip Code:29113-0310
Practice Address - Country:US
Practice Address - Phone:803-263-4795
Practice Address - Fax:803-263-4809
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist