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NPI Code Detail

MEDICARE: WILLIAM S WILLIS MD

MEDICARE: WILLIAM S WILLIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME0046327FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144216714
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM S WILLIS MD
Provider Business Mailing Address
First Line : PO BOX 17567
Second Line :
City : PENSACOLA
State : FL
Zip : 32522-7567
Country : US
Telephone Number : 850-475-3700
Fax Number :
Provider Business Practice Location Address
First Line : 4601 SPANISH TRL
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-5039
Country : US
Telephone Number : 850-969-2001
Fax Number : 850-433-8940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 11/10/2020

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