Provider Demographics
NPI:1376513044
Name:WILLIAMS, DAVID SYMMES (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SYMMES
Last Name:WILLIAMS
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 1:9459 OAKHURST CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-3373
Mailing Address - Country:US
Mailing Address - Phone:513-745-0523
Mailing Address - Fax:
Practice Address - Street 1:311 STRAIGHT ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1018
Practice Address - Country:US
Practice Address - Phone:513-559-2236
Practice Address - Fax:513-475-5252
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044938207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64867674Medicaid
OH0515517Medicaid
IN200100120Medicaid
OHP00332625Medicare PIN
KY64867674Medicaid
IN200100120Medicaid