Individual
KERRY ALLEN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1620 LIVE OAK ST, SUITE C, BEAUFORT, NC 28516
(252) 728-5737
(252) 728-5739
Mailing address
1620 LIVE OAK ST, SUITE C, BEAUFORT, NC 28516
(252) 728-5737
(252) 728-5739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30580
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8988112
—
NC
Enumeration date
12/29/2005
Last updated
12/03/2013
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