Individual
DR. DAVID RANDALL WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
203 TALLAPOOSA STREET, WADLEY, AL 36276
(256) 395-4757
(256) 395-6055
Mailing address
PO BOX 97, GADSDEN, AL 35902-0097
(256) 492-0131
(256) 494-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO288
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009995350
—
AL
05
—
110498
—
AL
Enumeration date
07/27/2006
Last updated
10/12/2011
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