Provider Demographics
NPI:1326694019
Name:WILLIAMSON EYE PROFESSIONALS P.C.
Entity Type:Organization
Organization Name:WILLIAMSON EYE PROFESSIONALS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-845-0246
Mailing Address - Street 1:125 DUKES CT
Mailing Address - Street 2:
Mailing Address - City:BROOKS
Mailing Address - State:GA
Mailing Address - Zip Code:30205-1640
Mailing Address - Country:US
Mailing Address - Phone:770-845-0246
Mailing Address - Fax:
Practice Address - Street 1:40 FISCHER CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:SHARPSBURG
Practice Address - State:GA
Practice Address - Zip Code:30277-3664
Practice Address - Country:US
Practice Address - Phone:678-621-8609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-17
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty