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NPI Code Detail

MEDICARE: DR. TERRY WILLS DPM

MEDICARE: DR. TERRY WILLS DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery PodiatristSC003314LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1203328OTHERUPMC
22520552/4574572PPOOTHERAETNA
38596-1327OTHERGEISINGER
41502116OTHERPAGATEWAY
599382OTHERHEALTH AMERICA
6WI548171OTHERBC/BS

General Provider Information

NPI Number : 1306841333
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY WILLS DPM
Provider Business Mailing Address
First Line : 711 LOGAN BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4165
Country : US
Telephone Number : 814-943-3668
Fax Number : 814-942-7635
Provider Business Practice Location Address
First Line : 711 LOGAN BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4165
Country : US
Telephone Number : 814-943-3668
Fax Number : 814-942-7635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 07/08/2007

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