Individual
DR. DIANNA MARIE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1305 EAST TAFT, SAPULPA, OK 74066-6033
(918) 224-8425
(918) 224-8426
Mailing address
1305 EAST TAFT, SAPULPA, OK 74066-6033
(918) 224-8425
(918) 224-8426
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2405
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111330D
—
OK
Enumeration date
09/21/2006
Last updated
05/06/2014
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