Individual
DR. WENDY SUMMER WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
531 SEVENTH AVENUE, ALBANY, GA 31701
(229) 883-3535
(229) 883-3783
Mailing address
531 SEVENTH AVENUE, ALBANY, GA 31701
(229) 883-3535
(229) 883-3783
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00306
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102I489616
MEDICARE PTAN
AL
Enumeration date
12/05/2010
Last updated
09/08/2020
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