Healthcare Provider Details

I. General information

NPI: 1144236969
Provider Name (Legal Business Name): DIABETES & ENDOCRINOLOGY ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4360 COOPER RD STE 201
CINCINNATI OH
45242
US

IV. Provider business mailing address

4360 COOPER RD STE 201
CINCINNATI OH
45242
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-0012
  • Fax: 513-861-2220
Mailing address:
  • Phone: 513-861-0012
  • Fax: 513-861-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY C WILLIAMS
Title or Position: PRESIDENT
Credential: MD
Phone: 513-861-0012