Provider Demographics
NPI:1457377525
Name:WILLIAMSON, THOMAS H (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 MARGIE DR
Mailing Address - Street 2:STE B
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7817
Mailing Address - Country:US
Mailing Address - Phone:478-333-3278
Mailing Address - Fax:478-333-3894
Practice Address - Street 1:310 MARGIE DR
Practice Address - Street 2:STE B
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7817
Practice Address - Country:US
Practice Address - Phone:478-333-3278
Practice Address - Fax:478-333-3894
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA042144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG71556Medicare UPIN