DR. RANDALL MATTHEW WILLIS (NPI# 1053569145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053569145 |
| Entity Type | Individual |
| Full Name | DR. RANDALL MATTHEW WILLIS |
| Credential | MD |
| Practice Address |
207 Brechin Ln Knoxville TN 37909-2165 |
| Mailing Address |
5508 Kingston Pike Suite 150 Knoxville TN 37919-5048 |
| Practice Telephone | 8654064044 |
| Mailing Telephone | 8655846464 |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
14380 | TN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902860356 | Randall J Willis | Urology | 801 S Walnut St, Stillwater, OK 74074-4226 | 2006-04-13 |
| 1033357264 | Randall Willis | Occupational Therapist | 835 N Expressway, Suite A, Brownsville, TX 78520-6831 | 2009-01-26 |
| Street Address |
207 BRECHIN LN |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37909-2165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326687534 | Rosalie Ting Mcglashen | Behavioral Analyst | 1508 Coleman Rd., Suites 105 and 110, Knoxville, TN 37909 | 2020-01-06 |
| 1770133597 | Renewal Healthcare | Family Medicine | 7035 Middlebrook Pike, Knoxville, TN 37909 | 2019-09-13 |
| 1417461211 | Lean Knox, LLC | Family Medicine | 1415 Old Weisgarber Rd. Ste 350, Knoxville, TN 37909 | 2017-12-01 |
| 1750757514 | Victor Brown | Counselor | 1451 Dowell Springs Blvd., Knoxville, TN 37909 | 2015-08-17 |
| 1083012488 | Melissa Wells Woodby | Marriage & Family Therapist | 6305 Lonas Dr, Knoxville, TN 37909 | 2014-12-17 |
| 1417375700 | David Francis Fair | Chiropractor | 1720 Tonalea Rd, Knoxville, TN 37909 | 2014-04-03 |
| 1295157519 | Danny Adkins, D.d.s. | Dentist | 1301 Old Weisgarber Road, Knoxville, TN 37909 | 2014-01-07 |
| 1376971085 | Quality Health Clinic LLC | Clinic/Center | 7348 Middlebrook Pike Suite D, Knoxville, TN 37909 | 2013-10-16 |
| 1952737942 | Martirea Fostine Jenkins Pratt | Nurse Practitioner | 930 Adell Ree Park Lane, Knoxville, TN 37909 | 2013-09-23 |
| 1104259324 | Dana Michelle Sweitzer | Nurse Practitioner | 1320 Old Weisgarber Road, Knoxville, TN 37909 | 2013-08-12 |
| Find all providers in zip 37909 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548786270 | Zachary Lance Allen | Preventive Medicine | 1 Blowers Blvd, Milligan College, TN 37682 | 2017-08-15 |
Please comment or provide details below to improve the information on DR. RANDALL MATTHEW WILLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.