Individual
DR. CHAD WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 2ND AVE STE C2, BOWLING GREEN, KY 42101-1791
(270) 780-2780
(270) 780-2755
Mailing address
PO BOX 2697, BOWLING GREEN, KY 42102-7697
(270) 745-1100
(270) 745-1156
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
42665
AL
207X00000X
Orthopaedic Surgery Physician
56988
KY
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
56988
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2016
Last updated
08/31/2022
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