Basic Information
| Provider Information | |||||||||
| NPI: | 1538246103 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 635156 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452635156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135285600 | ||||||||
| FaxNumber: | 5135289716 | ||||||||
| Practice Location | |||||||||
| Address1: | 463 OHIO PIKE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452550001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135285600 | ||||||||
| FaxNumber: | 5135289716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 12/14/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 35043583 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 100367460 | 01 | IN | MEDICAID | OTHER | 0409258 | 05 | OH | MEDICAID | 0661515 | 01 | AETNA HEALTH PLAN | OTHER | 3300094 | 01 | UNITED HEALTHCARE | OTHER | 64765175 | 01 | KY | MEDICAID | OTHER | 000000005278 | 01 | ANTHEM BLUE CROSS | OTHER | 460000897 | 01 | OH | RAILROAD MEDICARE | OTHER |