Healthcare Provider Details

I. General information

NPI: 1487357257
Provider Name (Legal Business Name): COREY WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W 10TH AVE
COLUMBUS OH
43210-1328
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8305
  • Fax: 614-685-7108
Mailing address:
  • Phone: 614-293-8305
  • Fax: 614-685-7108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.155828
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: