Provider Demographics
NPI:1124295589
Name:WILLIAMSON, JOHN CRAIG (EDD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CRAIG
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2732
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-2732
Mailing Address - Country:US
Mailing Address - Phone:907-224-2476
Mailing Address - Fax:
Practice Address - Street 1:11724 SEWARD HWY
Practice Address - Street 2:SUITE E
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-9708
Practice Address - Country:US
Practice Address - Phone:907-362-1804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK470103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling