Individual
DR. JEFFREY JON WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
835 E 145TH ST, BURNSVILLE, MN 55337-4623
(952) 595-1100
(612) 294-4903
Mailing address
11995 SINGLETREE LN, SUITE 500, EDEN PRAIRIE, MN 55344-5347
(952) 595-1301
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
02844
IA
2085R0202X
Diagnostic Radiology Physician
Primary
50359
MN
Other
Enumeration date
03/17/2006
Last updated
06/22/2015
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