Individual
DR. CAROL L WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2810 BURNET AVE, SUITE V, CINCINNATI, OH 45219-2447
(513) 961-5080
(513) 861-0500
Mailing address
2810 BURNET AVE, SUITE V, CINCINNATI, OH 45219-2447
(513) 961-5080
(513) 861-0500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
KY31932
KY
2084P0800X
Psychiatry Physician
Primary
OH44316
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0690659
—
OH
Enumeration date
01/13/2007
Last updated
05/19/2008
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