Individual
JEFFREY A WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(262) 292-3151
Mailing address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(262) 292-3151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1730
WI
Other
Enumeration date
07/16/2006
Last updated
12/10/2025
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