Provider Demographics
NPI:1013965227
Name:WILLS, WALTER N (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:N
Last Name:WILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1101 KING STREET, SUITE 100
Mailing Address - Street 2:LASIK PLUS VISION CENTER
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2944
Mailing Address - Country:US
Mailing Address - Phone:703-518-8913
Mailing Address - Fax:
Practice Address - Street 1:1101 KING STREET, SUITE 100
Practice Address - Street 2:LASIK PLUS VISION CENTER
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2944
Practice Address - Country:US
Practice Address - Phone:703-518-8913
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA208460207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology