Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jeffrey Todd Willis, MD

Individual provider General Practice Physician · NPI 1639100340

Dr. Jeffrey Todd Willis, MD is a General Practice Physician in Philadelphia, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1003 Holland Ave Ste 104
Philadelphia, MS 39350-2180
Phone: (601) 656-0010
Fax: (601) 656-0313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 12556 (MS)

Record details

NPI number1639100340
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 5, 2006
Last updated in NPPESNovember 16, 2020
Certification dateNovember 16, 2020
Mailing address1003 Holland Ave Ste 104, Philadelphia, MS 39350-2180

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