Provider Demographics
NPI:1891030011
Name:WILLIAMSON, EMILY JEANNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JEANNE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 BROWNSFERRY ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-4006
Mailing Address - Country:US
Mailing Address - Phone:256-874-0896
Mailing Address - Fax:
Practice Address - Street 1:313 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2556
Practice Address - Country:US
Practice Address - Phone:256-867-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016292183500000X
AL13690183500000X
TN23728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist