Individual
JOHN W. WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4830 KNIGHTSBRIDGE BLVD, SUITE A, COLUMBUS, OH 43214-2300
(614) 451-2174
(614) 451-1742
Mailing address
4830 KNIGHTSBRIDGE BLVD, SUITE A, COLUMBUS, OH 43214-2300
(614) 451-2174
(614) 451-1742
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-033759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0308705
—
OH
Enumeration date
09/20/2006
Last updated
07/12/2007
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