Individual
WALTER J WILLOUGHBY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10105 BANBURRY CROSS DR STE 355, LAS VEGAS, NV 89144-6649
(702) 409-3069
(702) 473-1869
Mailing address
10105 BANBURRY CROSS DR STE 355, LAS VEGAS, NV 89144-6649
(702) 409-3069
(702) 473-1869
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4004
NV
207RP1001X
Pulmonary Disease Physician
Primary
4004
NV
207RS0012X
Sleep Medicine (Internal Medicine) Physician
4004
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376592477
—
NV
Enumeration date
05/08/2006
Last updated
11/03/2025
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