Austin Glenn Willis, DO

Pediatrics Physician · Albuquerque, NM

Individual Active NPI

NPI number 1083034920

Practice location

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1063

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NPI record

NPI
1083034920
Entity type
Individual (Type 1)
Enumeration date
April 18, 2014
Last updated
July 21, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X A-2075-17 NM
Pediatrics Physician 208000000X BP1-0059381 TX

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone
(505) 923-6770
Fax
(505) 923-5354

About Dr. Willis

Austin Glenn Willis, DO is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 1100 Central Ave SE, Albuquerque, NM 87106-4930. The NPI number 1083034920 was assigned on April 18, 2014 and the record was last updated on July 21, 2022.

Dr. Willis lists 2 licenses in the registry: #A-2075-17 (NM) for Pediatrics Physician; #BP1-0059381 (TX) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Austin Glenn Willis, DO?

The NPI number is 1083034920.

What is the phone number of Dr. Willis?

The phone number listed for the practice location is (505) 841-1063.

Where is Dr. Willis located?

1100 Central Ave SE, Albuquerque, NM 87106-4930.

What is the taxonomy code for Dr. Willis?

The primary taxonomy code is 208000000X – Pediatrics Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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