Individual
DR. RANDALL MATTHEW WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 BRECHIN LN, KNOXVILLE, TN 37909-2165
(865) 406-4044
Mailing address
5508 KINGSTON PIKE, SUITE 150, KNOXVILLE, TN 37919-5048
(865) 584-6464
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
14380
TN
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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