Individual
DONALD ROGER WILLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 JESSE JEWELL PKWY SE, STE B, GAINESVILLE, GA 30501-3854
(770) 532-7092
(770) 536-0383
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
017748
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000095235C
—
GA
05
—
000095235D
—
GA
01
—
0908757
UHC
GA
01
—
10062468
AMERIGROUP
GA
01
—
1312061
CIGNA
GA
01
—
339676
WELLCARE
GA
01
—
52024086
BCBS
GA
Enumeration date
07/25/2006
Last updated
06/03/2009
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