Individual
DR. MICHAEL WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1 SHERIDAN SQ STE 102, KINGSPORT, TN 37660-7398
(423) 722-5200
Mailing address
1 SHERIDAN SQ STE 102, KINGSPORT, TN 37660-7398
(423) 722-5200
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPMOOOOOOO883
TN
Other
Enumeration date
05/31/2016
Last updated
06/22/2021
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