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NPI Code Detail

MEDICARE: DR. THEODORE WILLIAMS PH.D.

MEDICARE: DR. THEODORE WILLIAMS PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist4841OH

General Provider Information

NPI Number : 1568555043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THEODORE WILLIAMS PH.D.
Provider Business Mailing Address
First Line : 2 EASTON OVAL
Second Line : STE 450
City : COLUMBUS
State : OH
Zip : 43219-6035
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 EASTON OVAL
Second Line : STE 450
City : COLUMBUS
State : OH
Zip : 43219-6035
Country : US
Telephone Number : 614-475-9500
Fax Number : 614-475-9821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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