Provider Demographics
NPI:1235577669
Name:WILLOUGHBY, JANSI LAKSHMI (MD)
Entity Type:Individual
Prefix:
First Name:JANSI
Middle Name:LAKSHMI
Last Name:WILLOUGHBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANSI
Other - Middle Name:
Other - Last Name:MAGANTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50505 SCHOENHERR RD STE 290
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3141
Mailing Address - Country:US
Mailing Address - Phone:586-314-0080
Mailing Address - Fax:
Practice Address - Street 1:25689 KELLY RD STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4993
Practice Address - Country:US
Practice Address - Phone:586-445-5995
Practice Address - Fax:586-585-1281
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301116853207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine