Individual
MARK BASCOM WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
218 OLD MOCKSVILLE RD, STATESVILLE, NC 28625-1930
(704) 838-7091
(704) 838-7093
Mailing address
PO BOX 746, STATESVILLE, NC 28687-0746
(704) 838-7091
(704) 838-7093
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
97-00161
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891022N
—
NC
01
—
P00298227
MEDICARE RAILROAD
—
Enumeration date
08/31/2006
Last updated
02/19/2008
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