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General NPI Number Information
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NPI Number | 1154376259
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Entity Type | Individual
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Provider Name | CARL ROGASTON WILLIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 322 22ND AVE N STE 400
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City | NASHVILLE
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State | TN
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Zip | 37203-1870
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Country | US
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Telephone | 615-320-5090
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Fax | 615-320-1225
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Provider Business Mailing Address
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Address Line | 2004 HAYES ST STE 800
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City | NASHVILLE
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State | TN
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Zip | 37203-2659
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Country | US
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Telephone | 615-329-0570
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Fax | 615-329-0579
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 037952
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License Number State | TN
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