Willis, Roger Cecil

Willis, Roger Cecil is an individual health care provider with primary practice located at 790 E 5Th St , Coquille OR 97423-1755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Willis, Roger Cecil can be contacted via phone (541) 396-7295.

Contact Information

Primary practice address
790 E 5Th St Coquille OR 97423-1755
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD26451 Oregon

Profile Details

NPI number 1477501815
LBN Legal business name Willis, Roger Cecil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Oct 4th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477501815 NPPES
Oregon MEDICAID 165031

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