MEDICARE: JEFFREY WILLIAMSON II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1184570590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY WILLIAMSON II

Provider Business Mailing Address
First Line	:	629 WOODSWAY DR
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-9148
Country	:	US
Telephone Number	:	513-205-7904
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 WOODSWAY DR
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-9148
Country	:	US
Telephone Number	:	513-205-7904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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