Individual
JORDAN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 W 12TH AVE STE 105, EMPORIA, KS 66801
(620) 340-6181
(620) 342-6182
Mailing address
1201 W 12TH AVE, EMPORIA, KS 66801-2504
(620) 343-6800
(620) 341-7821
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
04-49597
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004648890002
—
KS
Enumeration date
06/11/2018
Last updated
07/11/2025
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