Individual
MR. JASON ALEXANDER WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHS, OTR/L, CHT
Contact information
Practice address
151 N EAGLE CREEK DR, SUITE 400, LEXINGTON, KY 40509-1889
(859) 264-8866
(859) 264-1167
Mailing address
2416 HIGHWAY 45 N, SUITE 400, COLUMBUS, MS 39705-1320
(859) 264-8866
(859) 264-1167
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
R2268
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000600569
BCBS FOR LHT
KY
Enumeration date
09/14/2005
Last updated
06/23/2016
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