Individual
BYRON H WILLIS
Active
Individual
BYRON H WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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