Williamson, Jerry
Williamson, Jerry is an sole proprietor health care provider with primary practice located at 1454 Madison Ave W , Immokalee FL 34142-2200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Williamson, Jerry can be contacted via phone (239) 658-3196.Contact Information
Primary practice address
1454 Madison Ave W
Immokalee FL 34142-2200
Phone: (239) 658-3196
Fax: (239) 658-3175
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME29350 | Florida |
Profile Details
| NPI number | 1770605677 |
|---|---|
| LBN Legal business name | Williamson, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 4th, 2007 |
| Last updated | Jun 6th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770605677 | NPPES |
| Florida | MEDICAID | 257304100 |
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