Randall Matthew Willis MD

NPI 1053569145 - Preventive Medicine - 2083S0010X

NPI Details
NPI 1053569145
Gender Male
Enumeration Date 09/03/2008
Last Updated 09/03/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
207 BRECHIN LN
KNOXVILLE TN, 37909-2165, US
Phone (865) 406-4044
Fax
Business Location
5508 KINGSTON PIKE
SUITE 150
KNOXVILLE TN, 37919-5048, US
Phone (865) 584-6464
Fax
Toxanomy
Taxonomy Code 2083S0010X
License State Tennessee
License Number 14380
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According to our database, Dr. Randall Matthew Willis MD NPI is 1053569145, taxonomy code is 2083S0010X and license number is 14380, license state is located at Tennessee. Randall Matthew Willis MD physically located at 207 Brechin Ln, Knoxville TN, 37909-2165. NPI Number Randall Matthew Willis MD has the Individual type.

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1053569145 NPI number is provided on an as is basis without warranty of any kind. 1053569145 is maintained by the National Plan & Provider Enumeration System. The contents of Randall Matthew Willis MD are for informational purposes only.