Willis, Dianna Marie
Willis, Dianna Marie is an individual health care provider with primary practice located at 1305 East Taft , Sapulpa OK 74066-6033. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Willis, Dianna Marie can be contacted via phone (918) 224-8425.Contact Information
Primary practice address
1305 East Taft
Sapulpa OK 74066-6033
Phone: (918) 224-8425
Fax: (918) 224-8426
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2405 | Oklahoma |
Profile Details
| NPI number | 1376641316 |
|---|---|
| LBN Legal business name | Willis, Dianna Marie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2006 |
| Last updated | May 6th, 2014 - 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 | 1376641316 | NPPES |
| Oklahoma | MEDICAID | 100111330D |
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