Individual
BYRON H WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1331 N 7TH ST STE 405, PHOENIX, AZ 85006-2754
(866) 974-2673
(866) 939-2673
Mailing address
1331 N 7TH ST STE 405, PHOENIX, AZ 85006-2754
(602) 254-3151
(602) 256-9581
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
30100
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188316200
DEPT. OF LABOR
AZ
01
—
1Z4006
HEALTHNET
AZ
05
—
686058
—
AZ
01
—
AZ0712750
BCBS
AZ
Enumeration date
07/25/2006
Last updated
04/23/2024
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