Provider Demographics
NPI:1548306202
Name:WILLS, NICHOLAS JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:WILLS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:710 COMMERCE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4925
Mailing Address - Country:US
Mailing Address - Phone:651-968-5042
Mailing Address - Fax:651-968-5904
Practice Address - Street 1:1185 TOWN CENTRE DR STE 100
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1188
Practice Address - Country:US
Practice Address - Phone:651-968-5230
Practice Address - Fax:651-994-3982
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2015-07-02
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Provider Licenses
StateLicense IDTaxonomies
MN47295207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery