DR. MARK A WILLIS (NPI# 1326136326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326136326 |
| Entity Type | Individual |
| Full Name | DR. MARK A WILLIS |
| Credential | D.D.S., M.S., P.A. |
| Practice Address |
5604 Ellsworth Rd Fort Smith AR 72903-3224 |
| Mailing Address |
135 N 49th St Fort Smith AR 72903-2317 |
| Practice Telephone | 4794847336 |
| Practice Fax Number | 4794848128 |
| Mailing Telephone | 4794521336 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2634 | AR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740269612 | Mark L Willis | Anesthesiology | 208 Haven Dr, Southeast Pain Mgmt Center, Dothan, AL 36301-2909 | 2006-01-10 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
| 1649423617 | Mark Willis | Otolaryngology | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2008-11-03 |
| 1326137514 | Mark C Willis Jr. | Orthopaedic Surgery | 1250 E Marshall St, Orthopaedic Surgery, Richmond, VA 23298-0510 | 2006-10-12 |
| 1215965751 | Mark A Willis | Physical Therapist | 1514 Owens St, Gadsden, AL 35904-4938 | 2006-06-30 |
| Street Address |
5604 ELLSWORTH RD |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72903-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932281805 | Mark A Willis Dds Ms Pa | Dentist | 5604 Ellsworth Rd, Fort Smith, AR 72903 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285280016 | Bhg L, LLC | Clinic/Center | 1501 Waldron Road, Ste 203, Fort Smith, AR 72903 | 2019-08-16 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1083272223 | Pediatric Therapy Connections LLC | Clinic/Center | 7601 Westminister Pl, Fort Smith, AR 72903 | 2019-06-03 |
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1104305853 | Baptist Health Services | Family Medicine | 5428 Ellsworth Rd Ste A, Fort Smith, AR 72903 | 2018-08-13 |
| 1417436171 | Baptist Health Services | Pediatrics | 5428 Ellsworth Rd Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1558840421 | Baptist Health Services | Family Medicine | 3808 Gary St Ste A, Fort Smith, AR 72903 | 2018-08-10 |
| 1316434707 | Md Weight Loss and Wellness, LLC | Dietitian, Registered | 3416 Old Greenwood Road, Fort Smith, AR 72903 | 2018-04-20 |
| 1942695572 | Donna K Morgan | Counselor | 2408 S. 51st Court Suite G, Fort Smith, AR 72903 | 2015-03-31 |
| 1346658242 | Shelby Mural Esry | Dentist | 3200 Rogers Ave. Suite 111, Fort Smith, AR 72903 | 2014-07-24 |
| Find all providers in zip 72903 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174665111 | David Alan Ciesla | Dentist | 3421 Old Greenwood Rd, Fort Smith, AR 72903-5461 | 2007-02-13 |
| 1891855789 | Timothy Wayne Lawrence | Dentist | 417 S 16th St, Fort Smith, AR 72901-4625 | 2006-12-11 |
| 1932147451 | Vent S Murphy Dds Ms Pllc | Dentist | 603 Lexington Ave, Fort Smith, AR 72901 | 2006-06-04 |
| 1134324296 | Vent Stephen Murphy | Dentist | 603 Lexington Ave, Fort Smith, AR 72901-4736 | 2007-06-19 |
| 1487775011 | River Valley Pediatric Dentistry Pllc | Dentist | 417 S 16th St, Fort Smith, AR 72901-4625 | 2007-04-02 |
| 1932281805 | Mark A Willis Dds Ms Pa | Dentist | 5604 Ellsworth Rd, Fort Smith, AR 72903 | 2006-10-20 |
| 1932166139 | James Lawrence Lee Jr. | Dentist | 1501 S Waldron Rd, Fort Smith, AR 72903-2574 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669098208 | Dr. Joseph M. Mazurek, Inc | Dentist | 6500 Baseline Rd, Little Rock, AR 72209-4732 | 2020-06-19 |
| 1508334400 | Smile Shoppe Fayetteville Jeffrey D. Rhodes Dds Ms Pllc | Dentist | 3484 W Wedington Dr, Fayetteville, AR 72704-5730 | 2018-11-08 |
| 1609234269 | Bethel Burris Oliver | Dentist | 2713 W Kings Highway, Paragould, AR 72450 | 2016-02-10 |
| 1114339926 | Amanda Hankins | Dentist | 5518 W Walsh Ln, Rogers, AR 72758-8947 | 2014-05-28 |
| 1881018786 | My Village Smiles, Pllc | Dentist | 1104 Poplar Pl, Rogers, AR 72756-4249 | 2014-02-12 |
| 1689974362 | Karen Anne Green | Dentist | 1607 E Rainforest Rd, Fayetteville, AR 72703 | 2010-10-27 |
| 1740508217 | Sarah Norris Farmer | Dentist | 3310 Hwy 5 N, Bryant, AR 72019-9031 | 2010-05-09 |
| 1760648174 | James L Bevans Pediatric Dentistry Pa | Dentist | 7409 Alcoa Road, Suite 5, Bryant, AR 72022 | 2008-08-05 |
| 1720242167 | Summer Barker Tyson | Dentist | 620 Southwest Dr, Jonesboro, AR 72401-5859 | 2008-07-15 |
| 1225211196 | John Michael Burrows | Dentist | 303 Bancario, Ste 11-12, Marion, AR 72364-2825 | 2007-12-13 |
| Find all providers with the same taxonomy | ||||
| City | FORT SMITH |
| Zip Code | 72903 |
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| 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.