Individual
JEFF R WILLIS
Active
Individual
JEFF R WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
0101059226
VA
207RG0100X
Gastroenterology Physician
Primary
56022
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100012482
MEDICARE RR
VA
01
—
15750
OPTIMA
VA
01
—
1659563799
GROUP NPI
VA
01
—
327082
ANTHEM
VA
01
—
5426240
AETNA
VA
05
—
5825041
—
VA
05
—
8905530
—
NC
Enumeration date
06/15/2006
Last updated
10/07/2024
Update your record
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