Provider Demographics
NPI:1356331649
Name:WILLIAMSON, DONALD C (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:C
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4048 EVANS AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9322
Mailing Address - Country:US
Mailing Address - Phone:239-332-5344
Mailing Address - Fax:239-332-7246
Practice Address - Street 1:4048 EVANS AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9322
Practice Address - Country:US
Practice Address - Phone:239-332-5344
Practice Address - Fax:239-332-7246
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0033141207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0867335OtherCIGNA
FL790519OtherAETNA
FL68214OtherBSFL
FL68214ZOtherMCR
FL68214ZOtherMCR