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Organization

R E WILLIFORD MD PA

Active
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Organization

R E WILLIFORD MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TARSHIA DONNELL (PRACTICE MANAGER)
(336) 633-0407
Entity
Organization

Contact information

Practice address
230 FOUST STREET, ASHEBORO, NC 27203
(336) 633-0407
(336) 633-0410
Mailing address
PO BOX 788, GREENSBORO, NC 27402-0788
(336) 343-7026
(336) 633-0410

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
9700286
NC
251S00000X
Community/Behavioral Health Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906946
—
NC
Enumeration date
03/30/2007
Last updated
04/10/2026
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