Individual
DR. CHAD D WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3214 KETHLEY RD, SHAWNEE, OK 74804-9625
(405) 273-5801
(405) 878-3794
Mailing address
PO BOX 258884, OKLAHOMA CITY, OK 73125-8884
(405) 231-3857
(405) 272-7977
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2006033639
MO
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
4875
OK
Other
Enumeration date
01/15/2007
Last updated
11/11/2016
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