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Individual

MR. JAMES WILLIS SOUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
175 S UNION BLVD STE 300, COLORADO SPRINGS, CO 80910-3126
(719) 365-1950
(719) 365-1951
Mailing address
175 S UNION BLVD STE 300, COLORADO SPRINGS, CO 80910-3126
(719) 365-1950
(719) 365-1951

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
797
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03086712
CO
Enumeration date
01/25/2006
Last updated
09/21/2016
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