Organization
WILLIS CLINIC
Active
Other names
Willis Clinic PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY W WILLIS (COO/PRACTICE MANAGER)
(870) 563-2545
Entity
Organization
Contact information
Practice address
616 W LEE AVE, OSCEOLA, AR 72370-3002
(870) 563-2545
(870) 563-2482
Mailing address
616 W LEE AVE, OSCEOLA, AR 72370-3002
(870) 563-2545
(870) 563-2482
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
E5031
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165422001
—
AR
Enumeration date
06/28/2007
Last updated
01/20/2021
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