Provider Demographics
NPI:1124015938
Name:WILLS, NOAH E III (MD)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:E
Last Name:WILLS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4166 SNAPFINGER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3411
Mailing Address - Country:US
Mailing Address - Phone:404-284-3200
Mailing Address - Fax:404-288-1745
Practice Address - Street 1:4166 SNAPFINGER WOODS DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3411
Practice Address - Country:US
Practice Address - Phone:404-284-3200
Practice Address - Fax:404-288-1745
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039014207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA444186602AMedicaid
GA444186602AMedicaid
GAF96909Medicare UPIN