Healthcare Provider Details

I. General information

NPI: 1205367182
Provider Name (Legal Business Name): ERIC WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 CEI DR
BLUE ASH OH
45242-5664
US

IV. Provider business mailing address

4445 LAKE FOREST DR STE 600
BLUE ASH OH
45242-3744
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-5133
  • Fax:
Mailing address:
  • Phone: 513-569-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number55075
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35141487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: