Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 39702 | TN |
NPI | 1447201967 |
---|---|
Provider Name | Dr. Jeffrey Donald Willers |
First Address | Nashville, TN 37203 |
Second Address | Nashville, TN 37203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 01/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3329865 | (05) | TN |
I23982 | (02) | TN |