Individual
GREGORY S WILLIS
Active
Individual
GREGORY S WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
MD2016-0015
NM
2085R0001X
Radiation Oncology Physician
Primary
MD28019
OR
2471R0002X
Radiation Therapy Radiologic Technologist
MD28019
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033138015
REGENCE BCBS
OR
01
—
140838
MEDICARE PTAN
OR
Enumeration date
09/02/2005
Last updated
07/31/2025
Update your record
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