Austin Glenn Willis
DO | Pediatrics | Male
Austin Glenn Willis, DO is a Albuquerque, New Mexico based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Austin Glenn Willis is
1100 Central Ave Se, Albuquerque, New Mexico - 87106-4930. He can be contacted on phone at
505-841-1063.
Austin Glenn Willis is a sole proprietor of his business.
NPI number (Unique professional ID) for Austin Glenn Willis is
1083034920 which was assigned by NPPES on 18 Apr, 2014 and it was last updated on 21 Jul, 2022.
Austin Glenn Willis license number is
A-2075-17 for Pediatrics (208000000X) in New Mexico.
Austin Glenn Willis is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Austin Glenn Willis basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Austin Glenn Willis |
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| Credential : | DO |
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| Gender : | Male |
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Business Address:
Austin Glenn Willis address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1100 Central Ave Se
Albuquerque, NM, 87106-4930
United States |
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| Phone Number : | 505-841-1063 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1083034920 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 18 Apr, 2014 |
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| Last Updated On : | 21 Jul, 2022 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Austin Glenn Willis are as mentioned. Primary taxonomy code for Austin Glenn Willis, DO is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | BP1-0059381 | TX |
| 208000000X | Pediatrics | Yes | A-2075-17 | NM |
Legacy Identifiers:
Other legacy medical identifiers of Austin Glenn Willis such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 32103778 | MEDICAID | NM | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 26666, Phs Provider Enrollment
Albuquerque, NM, 87125-6666
United States |
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| Phone Number : | 505-923-6770 |
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| Fax Number : | 505-923-5354 |
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Business Location:
Patients can refer following map for directions to
Austin Glenn Willis practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.