Provider Demographics
NPI:1356569693
Name:TITTLE, WILLIAM DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:TITTLE
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 1:6379 BRIDGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-2943
Mailing Address - Country:US
Mailing Address - Phone:513-941-6464
Mailing Address - Fax:513-941-6684
Practice Address - Street 1:6379 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-2943
Practice Address - Country:US
Practice Address - Phone:513-941-6464
Practice Address - Fax:513-941-6684
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH20-39579746Medicaid
OH20-39579746Medicaid