Healthcare Provider Details

I. General information

NPI: 1033529235
Provider Name (Legal Business Name): KIRVIA JOSEFINA WILLIAMS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MORRIS ST STE 300
CHARLESTON WV
25301-1853
US

IV. Provider business mailing address

400 ASSOCIATION DR STE 102
CHARLESTON WV
25311-1298
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-6441
  • Fax: 304-388-6445
Mailing address:
  • Phone:
  • Fax: 304-388-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4013
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number4013
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number14936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: