Provider Demographics
NPI:1437185220
Name:WILLIS, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:WILLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 E GALBRAITH RD # 300A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2754
Mailing Address - Country:US
Mailing Address - Phone:513-347-9999
Mailing Address - Fax:513-686-4217
Practice Address - Street 1:4700 E GALBRAITH RD # 300A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2754
Practice Address - Country:US
Practice Address - Phone:513-347-9999
Practice Address - Fax:513-686-4217
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-029649207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0138934Medicaid
OH0145208Medicare PIN
OHC00768Medicare UPIN