MICHAEL B WILLIS (NPI# 1164854154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164854154 |
| Entity Type | Individual |
| Full Name | MICHAEL B WILLIS |
| Credential | PA |
| Practice Address |
1501 Kings Hwy Shreveport LA 71103-4228 |
| Mailing Address |
1512 W Kirby Pl Shreveport LA 71103-3822 |
| Practice Telephone | 3186755000 |
| Mailing Telephone | 3186755000 |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2013-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | LA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598835910 | Michael Willis | Chiropractor | 910 Hampshire Rd Ste U, Westlake Village, CA 91361-2896 | 2006-11-09 |
| 1912091869 | Michael Kenneth Willis | Dentist | 47 Barkley Cir, Fort Myers, FL 33907-7531 | 2006-10-03 |
| 1912917238 | Michael S Willis | Dentist | 445 Henslee Drive, Ste B, Dickson, TN 37055 | 2006-08-09 |
| 1013933720 | Michael Jeffrey Willis | Counselor | 2833 E Genesee St, Syracuse, NY 13224-1524 | 2006-07-14 |
| 1528540382 | Michael Dwayne Willis | Student in an Organized Health Care Education/Training Program | 9808 Venice Blvd Ste 700, Culver City, CA 90232-6824 | 2018-08-29 |
| 1780032706 | Michael Willis | Podiatrist | 1850 Westen St, Bowling Green, KY 42104-4152 | 2016-05-31 |
| 1235363847 | Michael L Willis | Nurse Practitioner | 3201 Kings Highway, Beth Israel Medical Center, Brooklyn, NY 11234-2625 | 2009-05-11 |
| 1629101506 | Michael Willis | Psychologist | 6610 Se Quakervale Rd, Riverton, KS 66770-4185 | 2007-03-13 |
| 1194888776 | Michael Willis | Anesthesiology | 1051 Hickory St, Melbourne, FL 32901-1962 | 2006-12-18 |
| 1023197464 | Michael C. Willis | Orthopaedic Surgery | 2702 8th Ave N, Billings, MT 59101-1107 | 2006-11-05 |
| Street Address |
1501 KINGS HWY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1336747625 | Lana Nasief | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-09 |
| 1558968834 | Dinesh Regalla | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-08 |
| 1588261283 | Divleen Sidhu | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-06 |
| 1023624517 | Grace Hoffman | Pharmacist | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-20 |
| 1194330761 | Yousef Hasan | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1790399277 | Ricardo Murguia Fuentes | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1013521509 | Tahir Ahmad | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1376155309 | Ayesha Malik | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-20 |
| 1104438324 | Elleny Gutierrez | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103 | 2020-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740829217 | Bno Surgical Consultants, LLC | Physician Assistant | 303 Captain Hm Shreve Blvd, Shreveport, LA 71115 | 2020-01-02 |
| 1497394076 | Midday Surgical Consultants, LLC | Physician Assistant | 550 Linden St, Shreveport, LA 71104-4426 | 2019-12-31 |
| 1225677800 | Geaux Surgical Consultants, LLC | Physician Assistant | 370 Gallier Pl, Shreveport, LA 71106-8377 | 2019-12-31 |
| 1962041541 | Ace Surgical Consultants, LLC | Physician Assistant | 11045 Gabriels Path, Shreveport, LA 71106-7791 | 2019-12-31 |
| 1013499763 | Kristi Harrison Gaspard | Physician Assistant | 2508 Bert Koun Loop Ste 106, Shreveport, LA 71118-3175 | 2018-08-29 |
| 1295216125 | Heather White | Physician Assistant | 745 Olive St Ste 200, Shreveport, LA 71104-2246 | 2018-08-28 |
| 1285143669 | Kara Forbis | Physician Assistant | 2600 Kings Hwy Ste 420, Shreveport, LA 71103-3950 | 2017-09-28 |
| 1144748195 | Catherine Murphy Rogers | Physician Assistant | 2727 Hearne Ave Ste 300, Shreveport, LA 71103-3918 | 2017-08-30 |
| 1972955474 | Robin Egan | Physician Assistant | 1811 E Bert Koun Loop Ste 200, Shreveport, LA 71105-5766 | 2016-07-07 |
| 1457733198 | Brfhh Shreveport LLC | Physician Assistant | 1541 Kings Highway, Shreveport, LA 71103-4228 | 2015-06-18 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on MICHAEL B 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.