Healthcare Provider Details

I. General information

NPI: 1437185220
Provider Name (Legal Business Name): JAMES B. WILLIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 E GALBRAITH RD # 300A
CINCINNATI OH
45236-2754
US

IV. Provider business mailing address

4700 E GALBRAITH RD # 300A
CINCINNATI OH
45236-2754
US

V. Phone/Fax

Practice location:
  • Phone: 513-347-9999
  • Fax: 513-686-4217
Mailing address:
  • Phone: 513-347-9999
  • Fax: 513-686-4217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35-029649
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: