| Todd Willis Medical Clinic | |
|
1001 Holland Ave Suite 4 Philadelphia MS 39350-2161 | |
| (601) 656-0010 | |
| Not Available |
| Full Name | Todd Willis Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1001 Holland Ave, Philadelphia, Mississippi |
| Authorized Official Name and Position | Lawrence Graeber (CEO) |
| Authorized Official Contact | 6016631360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd Willis Medical Clinic 1001 Holland Ave Po Box 976 Philadelphia MS 39350-2161 Ph: (601) 656-0010 | Todd Willis Medical Clinic 1001 Holland Ave Suite 4 Philadelphia MS 39350-2161 Ph: (601) 656-0010 |
| NPI Number | 1750686341 |
|---|---|
| Provider Enumeration Date | 01/13/2011 |
| Last Update Date | 01/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750686341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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