Willis, Fred S

Willis, Fred S is an sole proprietor health care provider with primary practice located at 2600 Greenwood Rd , Shreveport LA 71103-3908. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Willis, Fred S can be contacted via phone (318) 212-4500.

Contact Information

Primary practice address
2600 Greenwood Rd Shreveport LA 71103-3908
Phone: (318) 212-4500
Fax: (318) 212-4143
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD.020188 Louisiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 020188 Louisiana

Profile Details

NPI number 1235131665
LBN Legal business name Willis, Fred S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2005
Last updated May 5th, 2026 - about 5 months 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 1235131665 NPPES
Louisiana MEDICAID 1390780

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