Provider Demographics
NPI:1083613806
Name:WASHINGTON, WILLIAM LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LLOYD
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-1609
Mailing Address - Country:US
Mailing Address - Phone:614-268-8221
Mailing Address - Fax:614-263-1891
Practice Address - Street 1:2339 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1609
Practice Address - Country:US
Practice Address - Phone:614-268-8221
Practice Address - Fax:614-263-1891
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060842207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0888348Medicaid
OH0888348Medicaid
OH0723372Medicare PIN
OH0723373Medicare PIN