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1801196589
CEDRIC R WILLIS
SHREVEPORT, LA
NPI
1801196589
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA PA.200392)
Enumeration Date
2010-10-27
Last Update Date
2022-08-12
Business Address
CEDRIC R WILLIS PA-C
8001 YOUREE DR STE 540
SHREVEPORT, LA 71115-2343
Phone number: 318-631-9121
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Mailing Address
CEDRIC R WILLIS PA-C
3217 MABEL ST
SHREVEPORT, LA 71103-4022
Phone number: 318-631-9121
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