Provider Demographics
NPI:1568638385
Name:WILLIAMSON, ERNIE GLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNIE
Middle Name:GLEN
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:UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
Mailing Address - Street 2:4200 EAST 9TH AVE.
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80262-0001
Mailing Address - Country:US
Mailing Address - Phone:303-315-7424
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
Practice Address - Street 2:4200 EAST 9TH AVE.
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80262-0001
Practice Address - Country:US
Practice Address - Phone:303-315-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program