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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932219649 | NPPES |
| Mississippi | Other | 830003891 | RAILROAD MEDICARE |
| Mississippi | Other | 64050757294 | RAILROAD MEDICARE |
| Mississippi | MEDICAID | 00118538 | RAILROAD MEDICARE |
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