Willis, Alphonso

Willis, Alphonso is an individual health care provider with primary practice located at 301 S 28Th Ave , Hattiesburg MS 39401-7233. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Willis, Alphonso can be contacted via phone (601) 288-8282.

Contact Information

Primary practice address
301 S 28Th Ave Hattiesburg MS 39401-7233
Phone: (601) 288-8282
Fax: (601) 288-8290
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 15624 Mississippi

Profile Details

NPI number 1932219649
LBN Legal business name Willis, Alphonso
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Feb 2nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932219649 NPPES
Mississippi Other 830003891 RAILROAD MEDICARE
Mississippi Other 64050757294 RAILROAD MEDICARE
Mississippi MEDICAID 00118538 RAILROAD MEDICARE

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