=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811073448
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICIA W WILLIAMS MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 03/11/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1193B PINEVIEW DR MORGANTOWN MENTAL HEALTH ASSOCIATES LLC
-----------------------------------------------------
City | MORGANTOWN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-599-1816
-----------------------------------------------------
Fax | 304-599-1459
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1193B PINEVIEW DR MORGANTOWN MENTAL HEALTH ASSOCIATES LLC
-----------------------------------------------------
City | MORGANTOWN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26505-2700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-599-1816
-----------------------------------------------------
Fax | 304-599-1459
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | WV11000
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------