Individual
DR. JAY WARREN WILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
495 YELLOWSTONE AVE, POCATELLO, ID 83201-4531
(208) 478-7422
(208) 478-1515
Mailing address
3049 E CENTER STREET, POCATELLO, ID 83201
(208) 221-4433
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O314
ID
Other
Enumeration date
07/21/2006
Last updated
07/05/2024
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