J. Todd Willis, MD Clinic

NPI #1053788240 in Philadelphia, Mississippi

Provider Information

NPI Number: 1053788240
Entity Type: Organization
Organization Name: J. Todd Willis, MD Clinic
Primary Specialty: General Practice
Enumeration Date: Aug 24, 2015
Last Updated: Aug 24, 2015

Practice Location

Address: 1003 HOLLAND AVENUE
Address 2: SUITE 104
City: Philadelphia
State: Mississippi
ZIP Code: 39350-2180
Phone: (601) 656-0010

Authorized Official

Name: CHERYL LEANN SAVELL
Title: CREDENTIALING COORDINATOR
Phone: (601) 663-1285

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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