Provider Demographics
NPI:1720030216
Name:WILLOUGHBY, RODNEY E (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:E
Last Name:WILLOUGHBY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC INFECTIOUS DISEASES
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-337-7070
Mailing Address - Fax:414-337-7093
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC INFECTIOUS DISEASES
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-337-7070
Practice Address - Fax:414-337-7093
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI463502080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1720030216Medicaid
000011354KOtherHUMANA
000011354KOtherHUMANA
WI1720030216Medicaid