Individual
PARK WEED WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
389 S 900 E, SALT LAKE CITY, UT 84102
(385) 282-2400
(385) 282-2401
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8471563-1205
UT
Other
Enumeration date
05/16/2011
Last updated
07/23/2018
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