Provider Demographics
NPI:1336038793
Name:WILLIAMS, CAROL FAY
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:FAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9708 MACCORKLE AVE
Mailing Address - Street 2:
Mailing Address - City:MARMET
Mailing Address - State:WV
Mailing Address - Zip Code:25315-1867
Mailing Address - Country:US
Mailing Address - Phone:304-220-2614
Mailing Address - Fax:
Practice Address - Street 1:9708 MACCORKLE AVE
Practice Address - Street 2:
Practice Address - City:MARMET
Practice Address - State:WV
Practice Address - Zip Code:25315-1867
Practice Address - Country:US
Practice Address - Phone:304-220-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant