Willis Medical LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD.018544 Issued in LA

Legal business name

WILLIS MEDICAL LLC

Practice address

600 Factory Outlet Dr
Suite 12
Arcadia, LA 71001-3057

Phone

(318) 263-4701

Fax

(318) 263-4704

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Miss Melinda Willis, MD

Title

Owner

Phone

(318) 263-4701

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Willis Medical LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Willis Medical LLC

  • Rural Health Clinic/Center
  • Arcadia, LA
  • NPI 1639445927
  NPD tax ID

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1750401964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 FACTORY OUTLET DR",
            "address_2": "SUITE 12",
            "city": "ARCADIA",
            "state": "LA",
            "postal_code": "710013057",
            "telephone_number": "318-263-4701",
            "fax_number": "318-263-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FACTORY OUTLET DR",
            "address_2": "SUITE 12",
            "city": "ARCADIA",
            "state": "LA",
            "postal_code": "710013057",
            "telephone_number": "318-263-4701",
            "fax_number": "318-263-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-263-4701",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.018544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "438135840C",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1909921",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shantelle White
• Shinika White, LMSW
• Sandy Whitman
• Richard Williamson
• Willis Medical LLC
• Jacqueline Willis
• Melinda Willis, MD
• Brenda Joyce Wortham
• Calvin Earl Wortham
• Charlene Wyatt

• Pediatrics Physician in Arcadia, LA
• Providers in Arcadia, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.