Donald J Willis D.O. P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A-822-85 Issued in NM

Legal business name

DONALD J WILLIS D.O. P.C.

Practice address

313 W Country Club Rd
Suite 9
Roswell, NM 88201-5804

Phone

(575) 624-2095

Fax

(575) 627-5721

NPI assigned

Mar 2, 2009

Last updated

Jun 19, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Donald J WillisNPI 1750347076

Title

D.O.

Phone

(575) 624-1333

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald Willis, DO

  • Family Medicine Physician
  • Roswell, NM
  • NPI 1750347076
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1093955189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W COUNTRY CLUB RD",
            "address_2": "SUITE 9",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015804",
            "telephone_number": "575-624-1333",
            "fax_number": "575-627-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W COUNTRY CLUB RD",
            "address_2": "SUITE 9",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015804",
            "telephone_number": "575-624-2095",
            "fax_number": "575-627-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD J WILLIS D.O. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "D.O.",
        "authorized_official_telephone_number": "575-624-1333",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-822-85",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Triet DO, DDS
• Callie M Dodson, CNM
• Crystal Dominguez
• Julianna Dominguez
• Donald E. Wenner M.D. F.a.C.S. P.C.
• Dove Hospice Corporation
• Dove Medical Corporation
• Cecil Dowdy
• Katrina Dowdy, CNM
• Brian L Doyle, PHARM D., RPH

• Family Medicine Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.