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1164854154
MICHAEL B WILLIS
SHREVEPORT, LA
NPI
1164854154
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2013-08-01
Last Update Date
2013-08-01
Business Address
-- MICHAEL B WILLIS PA
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-5000
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Mailing Address
-- MICHAEL B WILLIS PA
1512 W KIRBY PL
SHREVEPORT, LA 71103-3822
Phone number: 318-675-5000
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