Physician Compare National (NPI:1770523318)

HEALTHCARE PROVIDER: JOE TERRELL WILLS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1770523318
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163616020
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101104000662
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILLS
	Individual professional last name
Provider First Name	JOE
	Individual professional first name
Provider Middle Name	TERRELL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	462 MOUNT PLEASANT RD
	Group Practice or individual's line 1 address
City	THOMSON
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	308248123
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110111
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110028
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y