| Wayne S Willis Md Llc | |
|
3111 Peggy Bond Dr Pensacola FL 32504-5018 | |
| (850) 438-9755 | |
| (850) 438-0699 |
| Full Name | Wayne S Willis Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3111 Peggy Bond Dr, Pensacola, Florida |
| Authorized Official Name and Position | Wayne S. Willis (PRESIDENT) |
| Authorized Official Contact | 8504389755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne S Willis Md Llc 3111 Peggy Bond Dr Pensacola FL 32504-5018 Ph: (850) 438-9755 | Wayne S Willis Md Llc 3111 Peggy Bond Dr Pensacola FL 32504-5018 Ph: (850) 438-9755 |
| NPI Number | 1528039021 |
|---|---|
| Provider Enumeration Date | 02/01/2006 |
| Last Update Date | 02/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528039021 | NPI | - | NPPES |
| 274727800 | Medicaid | FL | |
| 98793 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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