Provider Demographics
NPI:1760552657
Name:WILLIAMS, DREW R (DC)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817A WEST UNION ST.
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701
Mailing Address - Country:US
Mailing Address - Phone:740-589-2000
Mailing Address - Fax:740-589-2002
Practice Address - Street 1:817 W UNION ST
Practice Address - Street 2:SUITE A
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-9411
Practice Address - Country:US
Practice Address - Phone:740-589-2000
Practice Address - Fax:740-589-2002
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2118087Medicaid
OH2118087Medicaid
OH85731Medicare UPIN