Provider Demographics
NPI:1508821273
Name:WILLIAMSON, LAWRENCE JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAMES
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1820
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-1820
Mailing Address - Country:US
Mailing Address - Phone:707-837-0170
Mailing Address - Fax:707-837-0177
Practice Address - Street 1:911 MEDICAL CENTER PLAZA
Practice Address - Street 2:SUITE 23
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-7817
Practice Address - Country:US
Practice Address - Phone:707-837-0170
Practice Address - Fax:707-837-0177
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA73495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H39456Medicare UPIN