Individual
DR. OWEN WINSTON WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., P.C.
Contact information
Practice address
121 E LEHIGH AVE, PHILADELPHIA, PA 19125-1011
(215) 739-2057
(215) 643-6558
Mailing address
710 LANTERN LN, P.O. BOX 383, BLUE BELL, PA 19422-1612
(215) 739-2057
(215) 643-6558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD021602E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007741300003
—
PA
Enumeration date
06/26/2007
Last updated
07/08/2007
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