Individual
THEODORE E WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-1506
(573) 884-5575
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD103499
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180017352
RR MEDICARE
MO
05
—
206647406
—
MO
01
—
P00415794
RAILROAD MEDICARE
MO
Enumeration date
05/04/2006
Last updated
09/25/2008
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