Individual
DR. TERRY L WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12 WHEELING AVE, GLEN DALE, WV 26038-1529
(304) 843-1445
(304) 843-1446
Mailing address
12 WHEELING AVE, GLEN DALE, WV 26038-1529
(304) 843-1445
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
645-D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720254
MOUNTAIN STATE BLUE CROSS
WV
01
—
410000871
RAILROAD MEDICARE
WV
01
—
645
HEALTH PLAN
WV
Enumeration date
10/27/2006
Last updated
07/10/2024
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