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Organization
J. TODD WILLIS, MD CLINIC
Active
Organization
J. TODD WILLIS, MD CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL LEANN SAVELL (CREDENTIALING COORDINATOR)
(601) 663-1285
Entity
Organization
Contact information
Practice address
1003 HOLLAND AVENUE, SUITE 104, PHILADELPHIA, MS 39350-2180
(601) 656-0010
(601) 656-0313
Mailing address
1003 HOLLAND AVE, SUITE 104, PHILADELPHIA, MS 39350-2180
(601) 656-0010
(601) 656-0313
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
12556
MS
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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