Provider Demographics
NPI:1003835513
Name:WILLIAMS, DONALD R (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 OLD STATE ROUTE 74
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-4238
Mailing Address - Country:US
Mailing Address - Phone:513-528-1505
Mailing Address - Fax:513-528-5982
Practice Address - Street 1:473 OLD STATE ROUTE 74
Practice Address - Street 2:SUITE 4
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4238
Practice Address - Country:US
Practice Address - Phone:513-528-1505
Practice Address - Fax:513-528-5982
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35040769W207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0357911Medicaid
OH0357911Medicaid
OHH138490Medicare PIN