Individual
DOUGLAS FRANK WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 MADISON AVE, ELMIRA, NY 14901-3204
(607) 734-2984
(607) 398-3411
Mailing address
207 MADISON AVE, ELMIRA, NY 14901-3204
(607) 734-2984
(607) 398-3411
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
175887
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180012684
RR MEDICARE
—
Enumeration date
09/07/2005
Last updated
01/20/2012
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