Individual
DR. KENNETH LEE WILLEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10 DOCTORS CIR, SUITE 2, SUPPLY, NC 28462-4089
(910) 755-6060
(910) 939-1659
Mailing address
10 DOCTORS CIR, SUITE 2, SUPPLY, NC 28462-4089
(910) 755-6060
(910) 755-6061
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
36621
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016UX
BCBS NC
NC
Enumeration date
08/09/2006
Last updated
07/09/2025
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