Provider Demographics
NPI:1356648752
Name:WILLIAMS, PAUL DAVID (PC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12834 WHEATON AVE
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8824
Mailing Address - Country:US
Mailing Address - Phone:614-866-1394
Mailing Address - Fax:
Practice Address - Street 1:12834 WHEATON AVE
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8824
Practice Address - Country:US
Practice Address - Phone:614-866-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0900186170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS