Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Willy David Booker, PA-C

Individual provider Physician Assistant · NPI 1417920794

Dr. Willy David Booker, PA-C is a Physician Assistant in Fort Stewart, Georgia. Graduated from University of Nebraska College of Medicine in 2004, 22 years ago. Practices with Southland Emergency Medical Services Consolidated, LLC, a 46-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
22
Trained at
University of Nebraska College of Medicine
Licensed in
NC
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5641
Phone: (912) 435-6633
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-09389 (NC)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1417920794
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 8, 2006
Last updated in NPPESSeptember 9, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Southland Emergency Medical Services Consolidated, Llc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Fort Stewart