Healthcare Provider Details

I. General information

NPI: 1922916048
Provider Name (Legal Business Name): JULIE GALE WILLIAMS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE GALE THACKERAY

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ
DAYTON OH
45404-1815
US

IV. Provider business mailing address

PO BOX 933432
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3600
  • Fax: 937-641-5802
Mailing address:
  • Phone: 937-641-5072
  • Fax: 937-641-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010535RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: