Willie, Jon Timothy

Willie, Jon Timothy is an individual health care provider with primary practice located at 4921 Parkview Pl Div Neurological Surgery, Ste 6B/6C, Saint Louis MO 63110-1032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Willie, Jon Timothy can be contacted via phone (314) 362-3577.

Contact Information

Primary practice address
4921 Parkview Pl Div Neurological Surgery, Ste 6B/6C Saint Louis MO 63110-1032
Phone: (314) 362-3577
Fax: (314) 362-2107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 2009027858 Missouri

Profile Details

NPI number 1194934034
LBN Legal business name Willie, Jon Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Apr 25th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194934034 NPPES
Missouri MEDICAID 200018234

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