Provider Demographics
NPI:1700361581
Name:WILLIAMS, CHAD E (CMS)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1610
Mailing Address - Country:US
Mailing Address - Phone:740-532-3767
Mailing Address - Fax:740-532-3385
Practice Address - Street 1:95 PRIVATE DRIVE 6999
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:OH
Practice Address - Zip Code:45619-8026
Practice Address - Country:US
Practice Address - Phone:740-532-3767
Practice Address - Fax:740-532-3385
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator