Individual
JAMES SCOTT WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2900 1ST AVE, #6019, HUNTINGTON, WV 25702-1241
(304) 399-0137
(304) 399-0138
Mailing address
PO BOX 8225, HUNTINGTON, WV 25705-0225
(304) 399-0137
(304) 399-0138
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
40738
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720989
MTN STATE BCBS
WV
05
—
0068445000
—
WV
05
—
0343079
—
OH
01
—
P00219014
RAILROAD MEDICARE
—
Enumeration date
09/26/2006
Last updated
06/26/2013
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