Provider Demographics
NPI:1407023880
Name:WILLIAMSON MEDICAL GROUP INC
Entity Type:Organization
Organization Name:WILLIAMSON MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-237-1450
Mailing Address - Street 1:306 HOSPITAL DRIVE
Mailing Address - Street 2:STE. 202-C
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4096
Mailing Address - Country:US
Mailing Address - Phone:606-237-1450
Mailing Address - Fax:606-237-1451
Practice Address - Street 1:306 HOSPITAL DR
Practice Address - Street 2:STE. 202-C
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4095
Practice Address - Country:US
Practice Address - Phone:606-237-1450
Practice Address - Fax:606-237-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18492207R00000X
WV70936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0079794000Medicaid
G39027Medicare UPIN