Provider Demographics
NPI:1538246103
Name:WILLIAMS, TIMOTHY C (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 635156
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5156
Mailing Address - Country:US
Mailing Address - Phone:513-528-5600
Mailing Address - Fax:513-528-9716
Practice Address - Street 1:463 OHIO PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-0001
Practice Address - Country:US
Practice Address - Phone:513-528-5600
Practice Address - Fax:513-528-9716
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043583207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100367460OtherMEDICAID
OH0409258Medicaid
0661515OtherAETNA HEALTH PLAN
3300094OtherUNITED HEALTHCARE
KY64765175OtherMEDICAID
000000005278OtherANTHEM BLUE CROSS
OH460000897OtherRAILROAD MEDICARE
OH0409258Medicaid
000000005278OtherANTHEM BLUE CROSS
D32410Medicare UPIN