DR. ROGER CECIL WILLIS (NPI# 1477501815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477501815 |
| Entity Type | Individual |
| Full Name | DR. ROGER CECIL WILLIS |
| Credential | MD |
| Practice Address |
600 Miluk Drive Coos Bay OR 97420 |
| Mailing Address |
3050 Tremont Street North Bend OR 97459 |
| Practice Telephone | 5418889494 |
| Practice Fax Number | 5418884435 |
| Mailing Telephone | 5418889494 |
| Mailing Fax Number | 5418884435 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2010-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD26451 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 165031 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770056491 | Roger F Willis IIi | Counselor | 4343 Williamsbourgh Dr, Sacramento, CA 95823-2006 | 2019-01-04 |
| 1639473531 | Roger E.t. Willis | Rehabilitation Practitioner | 2821 White Peaks Ave, N Las Vegas, NV 89081-2437 | 2011-01-06 |
| 1386683423 | Roger Willis | Emergency Medicine | 8026 Floyd Curl, San Antonio, TX 78229-3915 | 2006-06-05 |
| Street Address |
600 MILUK DRIVE |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982115366 | Coquille Indian Tribe | Pharmacy | 600 Miluk Drive, Coos Bay, OR 97420 | 2017-10-12 |
| 1558871228 | Coquille Indian Tribe | Pharmacy | 600 Miluk Drive, Coos Bay, OR 97420 | 2017-10-06 |
| 1447209846 | Patricia K Dudas | Nurse Practitioner | 600 Miluk Drive, Coos Bay, OR 97420 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518941350 | Robert William Gerber | Family Medicine | 2690 N 17th St, Coos Bay, OR 97420 | 2005-12-05 |
| 1295245108 | Davina Lynn Bledsoe | Family Medicine | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2017-10-05 |
| 1891170502 | Alyssa Sader | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2015-07-23 |
| 1275962581 | Craig Jackson | Family Medicine | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2013-11-06 |
| 1447538533 | Samir Bir Ale | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2011-07-24 |
| 1831342773 | Eduardo Erasto Santiago Ongkeko | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2008-10-23 |
| 1932216751 | James Alan Maddox | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2006-08-25 |
| 1184638124 | Jennifer Laurel Webster | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2006-07-27 |
| 1821047192 | Linda Marie Smith | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2006-05-06 |
| 1083684773 | Celeste Blanken | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2006-01-25 |
| Find all providers in COOS BAY | ||||
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| 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.