Willis, John

Willis, John is an individual health care provider with primary practice located at 1212 Bath Ave Alert, Ashland KY 41101-2696. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is his primary health care specialty. Willis, John can be contacted via phone (606) 329-8588.

Contact Information

Primary practice address
1212 Bath Ave Alert Ashland KY 41101-2696
Phone: (606) 329-8588
Fax: (606) 329-8195
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1679781470
LBN Legal business name Willis, John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2007
Last updated Jul 15th, 2020 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679781470 NPPES
Kentucky MEDICAID 33900168

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