Healthcare Provider Details
I. General information
NPI: 1801423645
Provider Name (Legal Business Name): WILLIAM COLEMAN NACE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2020
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
625 W WATERLOO ST STE 210A
CANAL WINCHESTER OH
43110-1005
US
IV. Provider business mailing address
PO BOX 7527
DUBLIN OH
43017-0727
US
V. Phone/Fax
- Phone: 614-533-7200
- Fax: 614-533-1343
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 34.015483 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 34.015483 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: