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General NPI Number Information
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NPI Number | 1831397124
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Entity Type | Individual
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Provider Name | MARK BILLY WILLITS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2007
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 6465 S YALE AVE SUITE 420
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City | TULSA
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State | OK
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Zip | 74136-7823
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Country | US
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Telephone | 918-502-8810
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Fax | 918-502-8815
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Provider Business Mailing Address
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Address Line | 6600 S YALE AVE SUITE 1400
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City | TULSA
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State | OK
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Zip | 74136-3347
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Country | US
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Telephone | 918-488-6001
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Fax | 918-488-6010
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 35.090321
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License Number State | OH
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