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General NPI Number Information
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NPI Number | 1245395029
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Entity Type | Individual
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Provider Name | BARBARA FAY WILLIS MD
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Gender | Female
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 119 FOREST GROVE RD
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City | HOMER
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State | LA
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Zip | 71040-7551
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Country | US
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Telephone | 337-718-2152
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Fax |
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Provider Business Mailing Address
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Address Line | 119 FOREST GROVE RD
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City | HOMER
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State | LA
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Zip | 71040-7551
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Country | US
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Telephone | 337-718-2152
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Fax |
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD2020-0318
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD2020-0318
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License Number State | NM
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