I E Willis Jr Dpm PC

NPI #1851579643 in Longview, Texas

Provider Information

NPI Number: 1851579643
Entity Type: Organization
Organization Name: I E Willis Jr Dpm PC
Primary Specialty: Podiatrist
Enumeration Date: Feb 5, 2008
Last Updated: Feb 21, 2008

Practice Location

Address: 609 E WHALEY ST
City: Longview
State: Texas
ZIP Code: 75601-6526
Phone: (903) 753-3316

Authorized Official

Name: DR. SELWYN EUGENE WILLIS, DPM
Title: DPM
Phone: (903) 753-3316

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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