Provider Demographics
NPI:1356884019
Name:WILLIAMSON, WILLIAM TOBEY (LAC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:TOBEY
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MECHANIC ST
Mailing Address - Street 2:SHARP'S POINT SOUTH, SUITE 202W
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-3513
Mailing Address - Country:US
Mailing Address - Phone:207-332-9941
Mailing Address - Fax:
Practice Address - Street 1:75 MECHANIC ST
Practice Address - Street 2:SHARP'S POINT SOUTH, SUITE 202W
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3513
Practice Address - Country:US
Practice Address - Phone:207-332-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC551171100000X
HI1168171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist