Individual
ERICK J WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2828 FIRST AVENUE, SUITE 305, HUNTINGTON, WV 25702
(304) 399-7565
(304) 399-7568
Mailing address
PO BOX 4190, BARBOURSVILLE, WV 25504-4190
(304) 399-4405
(304) 399-2526
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23279
WV
208000000X
Pediatrics Physician
99999
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000245860
—
OH
01
—
1073527
BRICKSTREET
WV
05
—
2909820
—
OH
05
—
3810012988
—
WV
01
—
6570317
CIGNA
WV
05
—
7100066820
—
KY
01
—
878669
CARELINK
WV
01
—
9865182
AETNA
WV
Enumeration date
05/09/2007
Last updated
04/22/2021
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