| Terell Willard, | |
|
1 Wahoo Ave, Groton, CT 06349-2324 | |
| (860) 694-3743 | |
| Not Available |
| Full Name | Terell Willard |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 1 Wahoo Ave, Groton, Connecticut |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225893993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0101286727 (Virginia) | Primary |
| 171000000X | Military Health Care Provider | (* (Not Available)) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Terell Willard, 1 Wahoo Ave, Groton, CT 06349-2324 Ph: Not Available | Terell Willard, 1 Wahoo Ave, Groton, CT 06349-2324 Ph: (860) 694-3743 |
Galen Alexander Golden, DO General Practice Medicare: Not Enrolled in Medicare Practice Location: 1 Wahoo Ave, Groton, CT 06349 Phone: 606-940-5212 |
Thomas Rogers, General Practice Medicare: Not Enrolled in Medicare Practice Location: Po Box 159, Groton, CT 06349 Phone: 860-694-2876 Fax: 860-694-3874 |
Dr. David Graham Southerland, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: Bldg 148, Trout Ave, Groton, CT 06349 Phone: 860-694-3263 Fax: 860-694-4809 |