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1245441005
FRED SPENCER WILLIS
SHREVEPORT, LA
NPI
1245441005
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 009828)
Enumeration Date
2007-05-24
Last Update Date
2015-02-02
Business Address
DR. FRED SPENCER WILLIS M.D.
1560 IRVING PL
SHREVEPORT, LA 71101-4604
Phone number: 318-212-1194
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Mailing Address
DR. FRED SPENCER WILLIS M.D.
11245 HERITAGE OAKS
SHREVEPORT, LA 71106-8386
Phone number: 318-797-8203
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