Individual
JAMES R WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16 WOODBINE LANE, DANVILLE, PA 17822-8029
(570) 271-8050
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
M7012
ID
207ND0101X
MOHS-Micrographic Surgery Physician
M7012
ID
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD054641L
PA
207NS0135X
Procedural Dermatology Physician
M7012
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000278700
—
ID
Enumeration date
05/22/2006
Last updated
08/10/2020
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