Willis, John M

Willis, John M is an individual health care provider with primary practice located at 252 Matlock Rd Ste 130 , Mansfield TX 76063-4295. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Willis, John M can be contacted via phone (682) 242-8990.

Contact Information

Primary practice address
252 Matlock Rd Ste 130 Mansfield TX 76063-4295
Phone: (682) 242-8990
Fax: (682) 242-8996
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X J0366 Texas

Profile Details

NPI number 1205891207
LBN Legal business name Willis, John M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Mar 23rd, 2022 - about 2 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 1205891207 NPPES
Texas MEDICAID 129827510
Texas Other 8X9688

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