Individual
DR. MARSHALL RAY WILLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HIGHWAY 28, GRANDVIEW MEDICAL CENTER, JASPER, TN 37347-3638
(423) 942-1674
(423) 942-9982
Mailing address
PO BOX 128, 195 MYERS AVE, GUILD, TN 37340-0128
(423) 942-1674
(423) 942-9982
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
011377
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3808477
—
TN
Enumeration date
09/27/2005
Last updated
07/08/2007
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