Individual
DR. MARK L WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 HAVEN DR, SOUTHEAST PAIN MGMT CENTER, DOTHAN, AL 36301-2909
(334) 793-8196
(334) 699-4757
Mailing address
1108 ROSS CLARK CIRCLE, SOUTHEAST PAIN MGMT CENTER, DOTHAN, AL 36301
(334) 793-8196
(334) 699-4757
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
00025952
AL
207LP2900X
Pain Medicine (Anesthesiology) Physician
00025952
AL
208VP0014X
Interventional Pain Medicine Physician
Primary
00025952
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51521334
BCBS OF AL
—
01
—
622443016A
MEDICAID
GA
Enumeration date
01/10/2006
Last updated
05/11/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us