Willis, Brandy C.
Willis, Brandy C. is an individual health care provider with primary practice located at 2646 Centennial Pl Ste A , Tallahassee FL 32308-0573. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Willis, Brandy C. can be contacted via phone (850) 702-0300.Contact Information
Primary practice address
2646 Centennial Pl Ste A
Tallahassee FL 32308-0573
Phone: (850) 702-0300
Fax: (850) 325-6015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME103588 | Florida |
Profile Details
| NPI number | 1457556268 |
|---|---|
| LBN Legal business name | Willis, Brandy C. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2007 |
| Last updated | Oct 12th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457556268 | NPPES |
| Florida | MEDICAID | 002105700 |
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