Provider Demographics
NPI:1598956161
Name:WILLIAMSON, JEFF (AUD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 9TH ST S
Mailing Address - Street 2:STE 102
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4402
Mailing Address - Country:US
Mailing Address - Phone:406-727-3115
Mailing Address - Fax:406-727-4484
Practice Address - Street 1:1102 9TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4402
Practice Address - Country:US
Practice Address - Phone:406-727-3115
Practice Address - Fax:406-727-4484
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5916231H00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist