Provider Demographics
NPI:1225219256
Name:WILLIS, ALAN K (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:K
Last Name:WILLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11491 US HIGHWAY 431
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0136
Mailing Address - Country:US
Mailing Address - Phone:256-894-6800
Mailing Address - Fax:256-894-6808
Practice Address - Street 1:11491 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0136
Practice Address - Country:US
Practice Address - Phone:256-894-6800
Practice Address - Fax:256-894-6808
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2019-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL26664208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery