Provider Demographics
NPI:1497038665
Name:WILLIAMSON, STEVEN BRADLEY (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRADLEY
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 N MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5032
Mailing Address - Country:US
Mailing Address - Phone:870-734-6229
Mailing Address - Fax:
Practice Address - Street 1:300 E TOWNSHIP ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3441
Practice Address - Country:US
Practice Address - Phone:479-582-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist