Organization
WILLIS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MELINDA WILLIS MD (OWNER)
(318) 263-4701
Entity
Organization
Contact information
Practice address
600 FACTORY OUTLET DR, SUITE 12, ARCADIA, LA 71001-3057
(318) 263-4701
(318) 263-4704
Mailing address
600 FACTORY OUTLET DR, SUITE 12, ARCADIA, LA 71001-3057
(318) 263-4701
(318) 263-4704
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.018544
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1909921
—
LA
01
—
438135840C
BLUE CROSS
LA
Enumeration date
03/30/2007
Last updated
05/09/2011
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