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
Phone: (215) 321-9896
Fax: (215) 321-4369
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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