MEDICARE: DR. FIELD F WILLINGHAM MD

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
1	207R00000X	Internal Medicine Physician	224035	MA
2	207RG0100X	Gastroenterology Physician	224035	MA
3	207RG0100X	Gastroenterology Physician	062634	GA

General Provider Information

NPI Number	:	1538150198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FIELD F WILLINGHAM MD

Provider Business Mailing Address
First Line	:	1365 CLIFTON RD NE STE B1266
Second Line	:	THE EMORY CLINIC
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-3184
Fax Number	:	404-778-5272

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE STE B1266
Second Line	:	THE EMORY CLINIC
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-3184
Fax Number	:	404-778-5272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	01/20/2016

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