Provider Demographics
NPI:1780600874
Name:WILLIAMSON, JAMES STEVEN (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405827
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:641 RB WILSON DR
Practice Address - Street 2:SUITE G
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-1733
Practice Address - Country:US
Practice Address - Phone:731-986-7400
Practice Address - Fax:731-986-7402
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4375721OtherAETNA
TN3164575Medicaid
TN4099088OtherBLUE CROSS BLUE SHIELD
739049OtherUNITED HEALTHCARE
TN9296OtherTLC
TNB03064Medicare UPIN
739049OtherUNITED HEALTHCARE
B03064Medicare UPIN