Individual
MARCUS ALLEN WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
554 W BASELINE RD, MESA, AZ 85210-6019
(480) 969-6234
Mailing address
2352 W ALTA VISTA RD, PHOENIX, AZ 85041-5326
(619) 288-0671
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S025534
AZ
1835P2201X
Ambulatory Care Pharmacist
S025534
AZ
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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