Willis, Donovan Scott

Willis, Donovan Scott is an sole proprietor health care provider with primary practice located at 3002 Rogers Ave , Fort Smith AR 72901-4232. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Willis, Donovan Scott can be contacted via phone (479) 785-2555.

Contact Information

Primary practice address
3002 Rogers Ave Fort Smith AR 72901-4232
Phone: (479) 785-2555
Fax: (479) 785-3555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C01497 Arkansas

Profile Details

NPI number 1558460295
LBN Legal business name Willis, Donovan Scott
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2006
Last updated May 21st, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558460295 NPPES
Oklahoma MEDICAID 200053830A
Oklahoma MEDICAID 156956001

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