Willis, Elliott Herschel

Willis, Elliott Herschel is an individual health care provider with primary practice located at 301 Oxford Valley Rd Suite 905A, Yardley PA 19067-7706. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Willis, Elliott Herschel can be contacted via phone (215) 321-9896.

Contact Information

Primary practice address
301 Oxford Valley Rd Suite 905A Yardley PA 19067-7706
Fax: (215) 321-4369
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS003457L Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25MB03196100 New Jersey

Profile Details

NPI number 1649218975
LBN Legal business name Willis, Elliott Herschel
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Nov 17th, 2013 - about 11 years ago

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 1649218975 NPPES
Pennsylvania Other 0022645000 KEYSTONE IBC
Pennsylvania Other 35651OS003457L KEYSTONE IBC
Pennsylvania MEDICAID 0070048520002 KEYSTONE IBC
Pennsylvania Other 6296514 KEYSTONE IBC
Pennsylvania Other 105263 KEYSTONE IBC
Pennsylvania Other 080084616 KEYSTONE IBC
Pennsylvania Other 30079314 KEYSTONE IBC

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