Organization
W A WILLIS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS L CARTER (OFFICE ADMINSTRATOR)
(910) 391-4588
Entity
Organization
Contact information
Practice address
2850 VILLAGE DR, SUITE 103, FAYETTEVILLE, NC 28304-3869
(910) 223-9801
(910) 223-9819
Mailing address
PO BOX 42005, FAYETTEVILLE, NC 28309-2005
(910) 223-9801
(910) 223-9819
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22449
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8988133
—
NC
Enumeration date
06/06/2012
Last updated
06/06/2012
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