Provider Demographics
NPI:1265466205
Name:THISTLETHWAITE, WILLIAM FRANK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANK
Last Name:THISTLETHWAITE
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 1:415 LOVELAND MIAMIVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6938
Mailing Address - Country:US
Mailing Address - Phone:513-340-4278
Mailing Address - Fax:513-728-4064
Practice Address - Street 1:8146 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2324
Practice Address - Country:US
Practice Address - Phone:513-588-3623
Practice Address - Fax:513-728-4064
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH038975208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0982772Medicaid
OH0982772Medicaid