Individual
ELLIOTT HERSCHEL WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
301 OXFORD VALLEY RD, SUITE 905A, YARDLEY, PA 19067-7706
(215) 321-9896
(215) 321-4369
Mailing address
301 OXFORD VALLEY RD, SUITE 905A, YARDLEY, PA 19067-7706
(215) 321-9896
(215) 321-4369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB03196100
NJ
207Q00000X
Family Medicine Physician
Primary
OS003457L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022645000
KEYSTONE IBC
PA
05
—
0070048520002
—
PA
01
—
080084616
PALMETTO GBA RAILROAD MED
—
01
—
105263
HIGHMARK BLUE SHIELD
PA
01
—
30079314
KEYSTONE MERCY
PA
01
—
35651OS003457L
HEALTH PARTNERS
PA
01
—
6296514
AETNA HMO
PA
Enumeration date
06/02/2006
Last updated
11/17/2013
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