Individual
GARTH J. WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PLAZA CT, SUITE A, EAST STROUDSBURG, PA 18301-8260
(570) 421-8842
(570) 476-5842
Mailing address
300 PLAZA CT, SUITE A, EAST STROUDSBURG, PA 18301-8260
(570) 421-8842
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MT186286
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023014720001
—
PA
Enumeration date
05/17/2007
Last updated
12/06/2013
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