Doctor Name: | PATRICIA A WILLEY |
NPI Number: | 1245424431 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | G78710 |
Business Practice Address: | 3000 Old Alabama Rd, Suite 119-608 Jackson & Coker Alpharetta, GA - 30022 |
Business Phone Number: | 8002722707 |
Business Fax Number: | |
Mailing Address: | 8680 W Christian Ave, DOS PALOS |
State: | CA |
Postal Code: | 936209659 |
Phone Number: | 2099855554 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2007 |
NPI Last Update Date: | 08/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G78710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |