Dr Devin R Willis, MD | |
16555 Manchester Rd Ste 100, Wildwood, MO 63040 | |
(636) 458-0646 | |
(636) 458-5008 |
Full Name | Dr Devin R Willis |
---|---|
Gender | Male |
Speciality | Sports Medicine |
Experience | 12 Years |
Location | 16555 Manchester Rd Ste 100, Wildwood, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295175057 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QS0010X | Family Medicine - Sports Medicine | 2016023372 (Missouri) | Primary |
208M00000X | Hospitalist | 2016023372 (Missouri) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Christian Hospital Northeast | Saint louis, MO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Physician Groups Lc | 3072421254 | 427 |
Entity Name | Physician Groups Lc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285664268 PECOS PAC ID: 3072421254 Enrollment ID: O20040220001157 |
Entity Name | Washington University |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679516033 PECOS PAC ID: 9830008770 Enrollment ID: O20040420000704 |
Entity Name | Mercy Clinic East Communities |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851335228 PECOS PAC ID: 7214827922 Enrollment ID: O20070521000006 |
Mailing Address | Practice Location Address |
---|---|
Dr Devin R Willis, MD 16555 Manchester Rd Ste 100, Wildwood, MO 63040-1220 Ph: (636) 458-0646 | Dr Devin R Willis, MD 16555 Manchester Rd Ste 100, Wildwood, MO 63040 Ph: (636) 458-0646 |
Bryan James Cannon, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16555 Manchester Rd, Suite 100, Wildwood, MO 63040 Phone: 636-458-0646 | |
Michael Joseph Richardson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16555 Manchester Rd, Suite 100, Wildwood, MO 63040 Phone: 636-458-0646 Fax: 636-458-5008 | |
Dr. Brenda Gail Izen, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2638 Highway 109 Ste 101, Wildwood, MO 63040 Phone: 636-821-2500 Fax: 636-821-2210 | |
Lisa C Burns, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 16555 Manchester Rd, Suite 100, Wildwood, MO 63040 Phone: 636-458-0646 |