Virgil V. Willard, II MD PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

137733 Issued in NC

Legal business name

VIRGIL V. WILLARD, II MD PA

Doing business as

Center for Image Discovery PA

Practice address

1011 N Lindsay St
High Point, NC 27262-3944

Phone

(336) 886-1667

Fax

(336) 886-5536

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Mitze S Segers

Title

Billing Supervisor

Phone

(336) 886-1667

Specialties & licenses 1

Addresses

Other names 1

• Center for Image Discovery PA Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1558416255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N LINDSAY ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623945",
            "telephone_number": "336-886-1667",
            "fax_number": "336-886-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N LINDSAY ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623944",
            "telephone_number": "336-886-1667",
            "fax_number": "336-886-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGIL V. WILLARD, II MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "SEGERS",
        "authorized_official_first_name": "MITZE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "336-886-1667",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "137733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Image Discovery PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in High Point, NC
• Providers in High Point, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.