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Individual

MALLORY LOUISE WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1171 GATEWOOD DRIVE, #101, AUBURN, AL 36830
(334) 821-2708
(334) 528-5420
Mailing address
1171 GATEWOOD DRIVE, #101, AUBURN, AL 36830
(334) 821-2708
(334) 528-5420

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2943
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2943
ALABAMA MEDICAL LICENSE
AL
Enumeration date
04/01/2019
Last updated
03/07/2023
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