Williamson, Jeffrey L
Williamson, Jeffrey L is an individual health care provider with primary practice located at 900 Main St Suite 530, Peoria IL 61602-1005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Williamson, Jeffrey L can be contacted via phone (309) 672-5975.Contact Information
Primary practice address
900 Main St Suite 530
Peoria IL 61602-1005
Phone: (309) 672-5975
Fax: (309) 655-1678
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036066240 | Illinois |
Profile Details
| NPI number | 1154302602 |
|---|---|
| LBN Legal business name | Williamson, Jeffrey L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Mar 30th, 2011 - about 15 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 | 1154302602 | NPPES |
| Illinois | MEDICAID | 0360662401 |
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