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Search › Oklahoma › 101YM0800X

Roger Willis

NPI 1598641367 · on the registry since 2025 · sole proprietor

Practice

Address
109 S Harrill Ave
Wagoner, OK 74467
Phone
(918) 485-0242
Fax
(918) 485-0204
Organisation at this address
Eagle Ridge Institute
Eagle Ridge Institute
Creoks Mental Health Services
Creoks Mental Health Services, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
97

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-08-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma