Healthcare Provider Details

I. General information

NPI: 1215867643
Provider Name (Legal Business Name): MR. RONALD L WILLINGHAM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 DAYTON ST
CINCINNATI OH
45214-2321
US

IV. Provider business mailing address

450 DAYTON ST
CINCINNATI OH
45214-2321
US

V. Phone/Fax

Practice location:
  • Phone: 513-485-9007
  • Fax:
Mailing address:
  • Phone: 513-485-9007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: