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General NPI Number Information
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NPI Number | 1679705925
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Entity Type | Individual
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Provider Name | FAYE WILLIAMSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 7133 SISSONVILLE DR
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City | SISSONVILLE
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State | WV
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Zip | 25320-9738
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Country | US
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Telephone | 304-984-1576
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Fax | 304-984-1565
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | DAWES
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State | WV
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Zip | 25054-0070
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Country | US
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Telephone | 304-734-2040
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Fax | 304-734-2047
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0000
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License Number State | WV
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