Willis, Donald
Willis, Donald is an sole proprietor health care provider with primary practice located at 313 W Country Club Rd Suite # 9, Roswell NM 88201-5804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Willis, Donald can be contacted via phone (505) 624-1333.Contact Information
Primary practice address
313 W Country Club Rd Suite # 9
Roswell NM 88201-5804
Phone: (505) 624-1333
Fax: (505) 234-1362
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A-822-85 | New Mexico |
Profile Details
| NPI number | 1750347076 |
|---|---|
| LBN Legal business name | Willis, Donald |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1750347076 | NPPES |
| New Mexico | MEDICAID | 40790 |
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