| Doctor Name: | JASON KEITH WILLOUGHBY |
| NPI Number: | 1124453204 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN, CRNP, NP-C |
| License Number: | 1-082033 |
| Business Practice Address: | 927 Medical Center Dr Bessemer, AL - 350226081 |
| Business Phone Number: | 2054818670 |
| Business Fax Number: | |
| Mailing Address: | 5528 Summer Place Pkwy, HOOVER |
| State: | AL |
| Postal Code: | 352446003 |
| Phone Number: | 2057895908 |
| Fax Number: | |
| NPI Enumeration Date: | 09/09/2013 |
| NPI Last Update Date: | 04/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 1-082033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |