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1235131665
FRED S WILLIS
SHREVEPORT, LA
NPI
1235131665
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: LA 020188)
Enumeration Date
2005-08-15
Last Update Date
2014-06-04
Business Address
-- FRED S WILLIS MD
2600 GREENWOOD RD
SHREVEPORT, LA 71103-3908
Phone number: 318-212-4500
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Mailing Address
-- FRED S WILLIS MD
PO BOX 32600
SHREVEPORT, LA 71130-2600
Phone number: 318-212-4877
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