Individual
BRIAN E WILLMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 W 21ST ST, STE W-8, CLOVIS, NM 88101
(505) 763-4479
(505) 763-6007
Mailing address
2200 W 21ST ST, CLOVIS, NM 88101-2011
(575) 760-7134
(575) 769-6464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
86358
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37572
—
NM
Enumeration date
03/17/2006
Last updated
10/21/2009
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