JAMES W WILLOUGHBY II DO PC (NPI# 1396015095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396015095 |
| Entity Type | Organization |
| Organization Name | JAMES W WILLOUGHBY II DO PC |
| Other Organization Name | LIBERTY HOLISTIC MEDICINE CENTER |
| Practice Address |
24-26 S Main St Ste A Liberty MO 64069 |
| Mailing Address |
24-26 S Main St Liberty MO 64069 |
| Practice Telephone | 8167810902 |
| Mailing Telephone | 8167810902 |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |
| Authorized Official Name | DR. JAMES W WILLOUGHBY II (OWNER) |
| Authorized Official Telephone | 8167810902 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
37014 | MO | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Liberty Holistic Medicine Center | Doing Business As Name - Organization |
| Street Address |
24-26 S MAIN ST STE A |
| City | LIBERTY |
| State | MO |
| Zip Code | 64069 |
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| 1891392312 | Donna Lynn Walsh | Dietitian, Registered | 10 Stagecoach Rd, Liberty, ME 04949-3133 | 2020-10-07 |
| 1114532710 | Candy Moore | Technician | 15956 Mclane Pike, Liberty, WV 25124-7248 | 2020-09-10 |
| 1033721659 | Breanna Moore | Technician | 15946 Mclane Pike, Liberty, WV 25124 | 2020-08-17 |
| 1003425448 | Herbert Douglas Geiger | Counselor | 949 Wellington Way, Liberty, MO 64068-1481 | 2020-07-30 |
| 1013532001 | Aspen Wayment | Student in an Organized Health Care Education/Training Program | 2531 Shaw Dr, Liberty, UT 84310-9705 | 2020-06-15 |
| Find all providers in LIBERTY | ||||
| Taxonomy Code | 207KI0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Clinical & Laboratory Immunology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215119508 | Allergy Asthma & Immunology Services, LLC | Allergy & Immunology | 1735 Elm Court, Jefferson City, MO 65101-4129 | 2007-11-29 |
Please comment or provide details below to improve the information on JAMES W WILLOUGHBY II DO PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.