Dr. Simon Matt Willis
Pain Medicine
114 Canal St Ste 503
Pooler
, Georgia 31322-4261
Dr. Simon Matt Willis
Pain Medicine
114 Canal St Ste 503
Pooler
, Georgia 31322-4261
(912) 450-6303
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About
Features
Specialties
- Pain Medicine
Languages spoken
- English
Location
First Address
- Dr. Simon Matt Willis
- 114 Canal St Ste 503
- Pooler, GA
- Zip : 31322-4261
- Fax : (912) 450-6303
- Phone : (912) 450-6300
Second Address
- Dr. Simon Matt Willis
- 114 Canal St Ste 503
- Pooler, GA
- Zip : 31322-4261
- Fax : (912) 450-6303
- Phone : (912) 450-6300
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 2081P2900X | Pain Medicine | 83377 | SC |
| Y | 2081P2900X | Pain Medicine | 84680 | GA |
National Provider Identifier
| NPI | 1356761191 |
|---|---|
| Provider Name | Dr. Simon Matt Willis |
| First Address | Pooler, GA 31322-4261 |
| Second Address | Pooler, GA 31322-4261 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/04/2014 |
| Last Update Date | 16/04/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.