| Madelyn Willis, | |
|
2010 W Katherine P Raines Rd Ste 300, Cleburne, TX 76033-7447 | |
| (432) 620-1120 | |
| Not Available |
| Full Name | Madelyn Willis |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 2 Years |
| Location | 2010 W Katherine P Raines Rd Ste 300, Cleburne, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942929666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA18349 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Texas Health Harris Methodist Hospital Cleburne | Cleburne, TX | Hospital |
| Texas Health Harris Methodist Hospital Southwest F | Fort worth, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oliver Street 5.01(a) Inc | 0042464125 | 169 |
| Chisholm Trail Orthopedics And Sports Medicine, Lllp | 7618916883 | 13 |
| Entity Name | Oliver Street 5.01(a) Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457695413 PECOS PAC ID: 0042464125 Enrollment ID: O20180626003255 |
| Mailing Address | Practice Location Address |
|---|---|
| Madelyn Willis, 412 Lair Ln, Canyon, TX 79015-4222 Ph: (806) 418-1326 | Madelyn Willis, 2010 W Katherine P Raines Rd Ste 300, Cleburne, TX 76033-7447 Ph: (432) 620-1120 |
Kevin B Baker, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 220 N Ridgeway Dr, Cleburne, TX 76033 Phone: 817-556-4800 Fax: 817-774-5015 |
Rachel Greer, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 895 N Nolan River Rd Ste 101, Cleburne, TX 76033 Phone: 817-641-8800 Fax: 817-641-8807 |
Ashley Nicole Gentry, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 220 N Ridgeway Dr, Cleburne, TX 76033 Phone: 817-556-4800 Fax: 817-774-5015 |
Brenden Ketchem, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 W Katherine P Raines Rd Ste 300, Cleburne, TX 76033 Phone: 817-566-3212 |
Jividen James Mccoy, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 W Katherine P Raines Rd Ste 300, Cleburne, TX 76033 Phone: 817-556-3212 |