| Doctor Name: | DR. HOWARD JAMES WILLIS |
| NPI Number: | 1093978108 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 0-177 |
| Business Practice Address: | 13540 Walsingham Rd Largo, FL - 337743546 |
| Business Phone Number: | 7275935492 |
| Business Fax Number: | 7275935440 |
| Mailing Address: | 4620 Grandview Ave, Ste 104 CHEYENNE |
| State: | WY |
| Postal Code: | 820094963 |
| Phone Number: | 3076376707 |
| Fax Number: | 3073330487 |
| NPI Enumeration Date: | 07/08/2008 |
| NPI Last Update Date: | 05/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0-177 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |