Provider Demographics
NPI:1770752057
Name:WILLIAMSON EYE GROUP, PC
Entity type:Organization
Organization Name:WILLIAMSON EYE GROUP, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:CUTHBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FAAO
Authorized Official - Phone:615-791-7030
Mailing Address - Street 1:2176 HILLSBORO RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-6230
Mailing Address - Country:US
Mailing Address - Phone:615-791-7030
Mailing Address - Fax:615-791-0277
Practice Address - Street 1:2176 HILLSBORO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-6230
Practice Address - Country:US
Practice Address - Phone:615-791-7030
Practice Address - Fax:615-791-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1162152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G700829OtherMEDICARE GROUP PTAN
TNU18852Medicare UPIN
TN1100190001Medicare NSC