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

Zachary Randall Willis

Individual provider Physician Assistant · NPI 1265041073

Zachary Randall Willis is a Physician Assistant in Potsdam, New York. Licensed in New York. Registered with an NPI since 2020.

Licensed in
NY
In the registry since
2020

Practice location Address checks out

50 Leroy St
Potsdam, NY 13676-1799
Phone: (315) 265-3300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 025386 (NY)

Record details

NPI number1265041073
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 28, 2020
Last updated in NPPESJuly 28, 2020
Certification dateJuly 28, 2020

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