Albert E. Willis, D.M.D., M.D., P.C.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

16039 Issued in AL

Legal business name

ALBERT E. WILLIS, D.M.D., M.D., P.C.

Practice address

540 Hughes Rd
Suite 6
Madison, AL 35758-8999

Phone

(256) 464-7873

Fax

(256) 464-7864

NPI assigned

Feb 8, 2007

Last updated

Aug 20, 2014By 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. Albert E. Willis II, D.M.D., M.D.NPI 1184024630

Title

President

Phone

(256) 464-7873

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.

• Albert Willis II, D.M.D., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Madison, AL
  • NPI 1184024630
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1720129307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 HUGHES RD",
            "address_2": "SUITE 6",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588999",
            "telephone_number": "256-464-7873",
            "fax_number": "256-464-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 HUGHES RD",
            "address_2": "SUITE 6",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588999",
            "telephone_number": "256-464-7873",
            "fax_number": "256-464-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT E. WILLIS, D.M.D., M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-464-7873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.M.D., M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "16039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery Clinic/Center in Madison, AL
• Providers in Madison, AL by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.