Willis, Nicholas
Willis, Nicholas is an individual health care provider with primary practice located at 1601 W 40Th Ave Suite 301, Pine Bluff AR 71603-6319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Willis, Nicholas can be contacted via phone (870) 541-4285.Contact Information
Primary practice address
1601 W 40Th Ave Suite 301
Pine Bluff AR 71603-6319
Phone: (870) 541-4285
Fax: (870) 541-4297
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | E5292 | Arkansas |
Profile Details
| NPI number | 1629292883 |
|---|---|
| LBN Legal business name | Willis, Nicholas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2007 |
| Last updated | Oct 19th, 2020 - about 5 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 | 1629292883 | NPPES |
| Arkansas | MEDICAID | 168857001 |
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