Individual
DR. TOM VANN WILLIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
F L T C 1131 CHAPEL CROSSING RD, BRUNSWICK, GA 31524-0001
(912) 280-5307
(912) 267-3196
Mailing address
114 MEWS CIR, SAINT SIMONS ISLAND, GA 31522-5153
(912) 638-3091
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10695
GA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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