NPI 1053569145

Randall Matthew Willis, MD

Practitioner Sports Medicine (Preventive Medicine) Physician Knoxville, TN

Practice location

Address: 207 Brechin Ln, Knoxville, TN 37909-2165
Phone: (865) 406-4044
Mailing address: 5508 Kingston Pike Suite 150, Knoxville, TN 37919-5048

Registered specialties

Sports Medicine (Preventive Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083S0010X Licence 14380 (TN)

Other Preventive Medicine providers in Tennessee →

Registry record

NPI: 1053569145
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Sep 2008
Record last updated: 3 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.