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Individual

STEPHEN W WILLIAMSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
6533 W EMERALD ST, BOISE, ID 83704-8737
(208) 367-4170
(208) 367-8135
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1064
ID
363A00000X
Physician Assistant
PA03539
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA03539
PHYSICIAN ASSISTANTS
TX
Enumeration date
08/20/2006
Last updated
02/04/2015
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