Dr David Randall Willis, DO is a medicare enrolled "Family Medicine" physician in Wadley, Alabama. He went to Nova Southeastern College Of Osteo Medicine and graduated in 1990 and has 35 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Medical Center Plus Llc and his current practice location is
203 Tallapoosa Street, Wadley, Alabama. You can reach out to his office (for appointments etc.) via phone at
(256) 395-4757.
Dr David Randall Willis is licensed to practice in Alabama (license number DO288) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1710901970.
Physician's Profile
| Full Name | Dr David Randall Willis |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 35 Years |
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| Location | 203 Tallapoosa Street, Wadley, Alabama |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr David Randall Willis attended and graduated from Nova Southeastern College Of Osteo Medicine in 1990
NPI Data:
- NPI Number: 1710901970
- Provider Enumeration Date: 07/27/2006
- Last Update Date: 10/12/2011
Medicare PECOS Information:
- PECOS PAC ID: 8224091392
- Enrollment ID: I20041109001102
Medical Identifiers
Medical identifiers for Dr David Randall Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710901970 | NPI | - | NPPES |
| 110498 | Medicaid | AL | |
| 009995350 | Medicaid | AL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | DO288 (Alabama) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Medical Center Plus Llc | 7911317755 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr David Randall Willis allows following entities to bill medicare on his behalf.
| Entity Name | American Family Care, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669429080
PECOS PAC ID: 9739087818
Enrollment ID: O20031229000157 |
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| Entity Name | Medical Center Plus Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104459411
PECOS PAC ID: 7911317755
Enrollment ID: O20201105000874 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David Randall Willis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr David Randall Willis, DO
Po Box 97,
Gadsden, AL 35902-0097
Ph: (256) 492-0131 | Dr David Randall Willis, DO
203 Tallapoosa Street,
Wadley, AL 36276
Ph: (256) 395-4757 |
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