Provider Demographics
NPI:1992930085
Name:WILLIAMSON FAMILY CARE CENTER
Entity type:Organization
Organization Name:WILLIAMSON FAMILY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DONOVAN
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-235-2930
Mailing Address - Street 1:859 ALDERSON ST.
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661
Mailing Address - Country:US
Mailing Address - Phone:304-235-2500
Mailing Address - Fax:304-235-1576
Practice Address - Street 1:859 ALDERSON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3215
Practice Address - Country:US
Practice Address - Phone:304-235-2500
Practice Address - Fax:304-235-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV46089282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural