J. TODD WILLIS, MD CLINIC
NPI 1053788240
General Practice in Philadelphia, MS

Q: What is J. Todd Willis, MD Clinic's NPI number?

The NPI number for J. Todd Willis, MD Clinic is 1053788240. It was assigned to this organization in the NPPES registry on August 24, 2015.

Q: What is J. Todd Willis, MD Clinic's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since August 24, 2015

1003 HOLLAND AVENUE, SUITE 104, PHILADELPHIA, MS 39350(601) 656-0010(601) 656-0313 Get Directions Write a Review

NPPES record last updated: August 24, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About J. Todd Willis, Md Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

J. TODD WILLIS, MD CLINIC (NPI 1053788240) is a healthcare organization registered as a general practice in Philadelphia, Mississippi and active in the NPI registry since August 2015. The organization lists Cheryl Leann Savell, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1053788240

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameJ. TODD WILLIS, MD CLINIC

Location Address1003 HOLLAND AVENUE, SUITE 104Philadelphia, MS 39350-2180

Mailing Address1003 Holland Ave, Suite 104Philadelphia, MS 39350-2180 · (601) 656-0010 · Fax (601) 656-0313

Phone(601) 656-0010

Fax(601) 656-0313

Organization SubpartNo

Authorized OfficialCheryl Leann SavellCredentialing Coordinator · (601) 663-1285

Enumeration DateAugust 24, 2015

✔ NPI 1053788240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in MS · 12556

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1003 HOLLAND AVENUE, Philadelphia, MS 39350

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is J. Todd Willis, MD Clinic's NPI number?

The NPI number for J. Todd Willis, MD Clinic is 1053788240. It was assigned to this organization in the NPPES registry on August 24, 2015.

Where is J. Todd Willis, MD Clinic located?

J. Todd Willis, MD Clinic is located at 1003 Holland Avenue Suite 104, Philadelphia, MS 39350. The listed phone number is (601) 656-0010.

What is J. Todd Willis, MD Clinic's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for J. Todd Willis, MD Clinic was last updated on August 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.