Organization
CHAD D. WILLIS, D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESE A SIMON (CRENTIALING)
(580) 531-0022
Entity
Organization
Contact information
Practice address
5402 SW LEE BLVD, LAWTON, OK 73505-9521
(580) 531-0022
(580) 531-0026
Mailing address
5402 SW LEE BLVD, LAWTON, OK 73505-9521
(580) 531-0022
(580) 531-0026
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4875
OK
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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