AUSTIN GLENN WILLIS


Address: 1100 Central Ave Se, Albuquerque, NM 87106-4930
Phone: 5058411063

AUSTIN GLENN WILLIS (NPI# 1083034920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083034920
Entity Type Individual
Full Name AUSTIN GLENN WILLIS
Credential DO
Practice Address 1100 Central Ave Se
Albuquerque
NM 87106-4930
Mailing Address Po Box 26666
Phs Provider Enrollment
Albuquerque
NM 87125-6666
Practice Telephone 5058411063
Mailing Telephone (505) 923-6770
Mailing Fax Number 5059235354
Enumeration Date 2014-04-18
Last Update Date 2017-09-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics A-2075-17 NM Allopathic & Osteopathic Physicians
N 208000000X Pediatrics BP1-0059381 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NM 32103778 05

Other Providers AUSTIN WILLIS

NPI Name Taxonomy Address Enumeration
1588145429 Austin Tyler Willis Dentist 402 Carriage Dr, Beckley, WV 25801-2806 2018-08-28
1609375732 Austin Willis Behavior Technician 90 Compark Rd Ste D, Centerville, OH 45459-4982 2018-02-05

Office Location

Street Address 1100 CENTRAL AVE SE
City ALBUQUERQUE
State NM
Zip Code 87106-4930

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457354243 Robert A Biazak Anesthesiology 1100 Central Ave Se, Albuquerque, NM 87106-4930 2005-05-24
1043811045 Nathan Michael Mabon Registered Nurse 1100 Central Ave Se, Albuquerque, NM 87106-4934 2020-11-05
1588274039 Caryn Hong Thi Nguyen Pharmacist 1100 Central Ave Se, Albuquerque, NM 87106-4930 2020-08-07
1396355996 Hope Jessica Montoya Internal Medicine 1100 Central Ave Se, Albuquerque, NM 87106-4930 2020-08-07
1326658030 Chaniece Doyle Pharmacist 1100 Central Ave Se, Albuquerque, NM 87106-4930 2020-08-06
1598375495 Daniel Sanchez Pharmacist 1100 Central Ave Se, Albuquerque, NM 87106-4930 2020-08-05
1215551478 Yousuf Shakir Pharmacist 1100 Central Ave Se, Albuquerque, NM 87106-4930 2020-06-03
1861037715 Jeffrey Lillie Nurse Anesthetist, Certified Registered 1100 Central Ave Se, Albuquerque, NM 87106-4930 2019-11-14
1396387502 Justin Schmetterer Pharmacist 1100 Central Ave Se, Albuquerque, NM 87106-4930 2019-10-09
1669023602 Jalayne Faulhaber Nurse Practitioner 1100 Central Ave Se, Albuquerque, NM 87106-4930 2019-09-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629679808 Jorge Licano Student in an Organized Health Care Education/Training Program Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 2020-11-04
1730780032 Joseph Sanchez Student in an Organized Health Care Education/Training Program (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 2020-11-03
1336746205 Evan Laub Pharmacist 2950 Central Ave. Sw, Albuquerque, NM 87106 2020-10-05
1487203154 Theresa Martinez Technician 5680 Avedon Dr. Se, Albuquerque, NM 87106 2019-09-05
1205300647 Louis Mayer II Specialist/Technologist 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 2019-01-18
1235633355 Terrena Grace Vigil Brady Occupational Therapist 1001 Yale Blvd, Albuquerque, NM 87106 2018-03-22
1205355195 Yaritza Ruiz Specialist/Technologist 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 2017-09-12
1457873382 Cynthia Bluhm Registered Nurse 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 2017-07-12
1295265882 Hallie Chancellor Behavior Technician 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 2017-06-15
1780111757 Jiana Hook Physical Medicine & Rehabilitation 1414 University Blvd. Se, Albuquerque, NM 87106 2017-05-22
Find all providers in zip 87106

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851814784 Ally Renee Funkhouser Dye Pediatrics 2130 Eubank Blvd Ne, Albuquerque, NM 87112 2017-07-23
1528417953 Sofia Michelle Markee Pediatrics 1 University of New Mexico Pediatric Department, Albuquerque, NM 87131-0001 2016-06-07
1619363751 Lauren N Gabreski Pediatrics Us Air Force, 377 Mdg/sghc, 2050a Second Street Se, Albuquerque, NM 87117-5522 2015-04-15
1174918197 Ross Newman Pediatrics 2211 Lomas Blvd Ne # 3acc, Albuquerque, NM 87106-2719 2015-04-06
1942612650 Amy M Rouse Pediatrics 933 Bradbury Dr Se Ste 222, Albuquerque, NM 87106 2014-05-29
1215362017 Deborah Mcgrew Md LLC Pediatrics 1615 University Blvd Ne, Albuquerque, NM 87102-1717 2013-09-11
1477986065 Gypsum Medical Associates of New Mexico, PC Pediatrics Building 9200, Area Y, Kirtland Air Force Base-east, Albuquerque, NM 87115 2013-08-19
1750653069 Molina Healthcare of New Mexico Pediatrics 7317 Central Ne, Albuquerque, NM 87108-2015 2012-02-01
1720370612 Alfonso Belmonte Pediatrics Unm Department of Pediatrics Msc10 5590, Albuquerque, NM 87131-0001 2011-05-10
1326288010 Minh N. Ho Pediatrics 4701 Montgomery Boulevard Ne, Albuquerque, NM 87109 2009-02-20
Find all providers in ALBUQUERQUE

Competitor

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City ALBUQUERQUE
Zip Code 87106

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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