Individual
MISS PAULA SUZANNE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14089 ABERCORN ST, SAVANNAH, GA 31419-1966
(912) 350-2121
(912) 350-2145
Mailing address
14089 ABERCORN ST, SAVANNAH, GA 31419-1966
(912) 350-2121
(912) 350-2145
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003144
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003121625A
—
GA
05
—
003121625B
—
GA
05
—
003121625C
—
GA
05
—
003121625D
—
GA
05
—
003121625E
—
GA
01
—
P01036869
RAILROAD MEDICARE
GA
01
—
P01110461
RAILROAD MEDICARE
GA
Enumeration date
02/16/2009
Last updated
09/12/2014
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