Mr Jeramy C Willis, KCSA - Physician Assistant in Bowling Green, KY

Mr Jeramy C Willis, KCSA is a Physician Assistant - Surgical based in Bowling Green, Kentucky. Mr Jeramy C Willis is licensed to practice in Kentucky (license number SA164) and his current practice location is 1945 Scottsville Rd, B2 Pmb 397, Bowling Green, Kentucky. He can be reached at his office (for appointments etc.) via phone at (270) 781-4828.

NPI number for Mr Jeramy C Willis is 1780867473 and his current mailing address is 1945 Scottsville Rd. B2 Pmb 397, Bowling Green, Kentucky. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1780867473.

Contact Information

Mr Jeramy C Willis, KCSA
1945 Scottsville Rd, B2 Pmb 397,
Bowling Green, KY 42104-3376
(270) 781-4828
(270) 781-4828



Provider's Profile

Full NameMr Jeramy C Willis
GenderMale
SpecialityPhysician Assistant - Surgical
Location1945 Scottsville Rd, Bowling Green, Kentucky
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1780867473
  • Provider Enumeration Date: 12/17/2007
  • Last Update Date: 12/17/2007

Medical Identifiers

Medical identifiers for Mr Jeramy C Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780867473NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical SA164 (Kentucky)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jeramy C Willis is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Jeramy C Willis, KCSA
1945 Scottsville Rd. B2 Pmb 397,
Bowling Green, KY 42104

Ph: (270) 781-4828
Mr Jeramy C Willis, KCSA
1945 Scottsville Rd, B2 Pmb 397,
Bowling Green, KY 42104-3376

Ph: (270) 781-4828

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Brandy L Pile, KCSA
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Practice Location: 250 Park St, Bowling Green, KY 42101
Phone: 270-781-4828    Fax: 270-781-4828

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