Provider Demographics
NPI:1841558517
Name:WILLIG, JEFFREY H (LMT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:WILLIG
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 BANNING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-5573
Mailing Address - Country:US
Mailing Address - Phone:513-550-4279
Mailing Address - Fax:
Practice Address - Street 1:2909 BANNING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-5573
Practice Address - Country:US
Practice Address - Phone:513-550-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18197171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor