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General NPI Number Information
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NPI Number | 1174959795
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Entity Type | Organization
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Legal Business Name | WILLIS CLINIC EXPRESS
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 616 W LEE AVE STE 2A
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City | OSCEOLA
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State | AR
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Zip | 72370-3002
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Country | US
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Telephone | 870-622-9212
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Fax | 870-576-4350
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Provider Business Mailing Address
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Address Line | 616 W LEE AVE STE 2A
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City | OSCEOLA
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State | AR
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Zip | 72370-3002
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Country | US
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Telephone | 870-622-9212
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Fax | 870-576-4350
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. TIMOTHY W WILLIS
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Credential | MPA
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Telephone | 870-622-9212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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