| Erick J Willis, MD | |
|
2828 First Avenue, Suite 305, Huntington, WV 25702 | |
| (304) 399-7565 | |
| (304) 399-7568 |
| Full Name | Erick J Willis |
|---|---|
| Gender | Male |
| Speciality | Pediatric Medicine |
| Experience | 20 Years |
| Location | 2828 First Avenue, Huntington, West Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912111097 | NPI | - | NPPES |
| 1073527 | Other | WV | BRICKSTREET |
| 3810012988 | Medicaid | WV | |
| 2909820 | Medicaid | OH | |
| 6570317 | Other | WV | CIGNA |
| 7100066820 | Medicaid | KY | |
| 878669 | Other | WV | CARELINK |
| 000000245860 | Medicaid | OH | |
| 9865182 | Other | WV | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 99999 (West Virginia) | Secondary |
| 208000000X | Pediatrics | 23279 (West Virginia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St. Mary's Medical Management, Llc | 5890897151 | 81 |
| Entity Name | St. Mary's Medical Management, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922155217 PECOS PAC ID: 5890897151 Enrollment ID: O20070216000690 |
| Mailing Address | Practice Location Address |
|---|---|
| Erick J Willis, MD Po Box 4190, Barboursville, WV 25504-4190 Ph: (304) 399-4405 | Erick J Willis, MD 2828 First Avenue, Suite 305, Huntington, WV 25702 Ph: (304) 399-7565 |
Dr. Tanya G Bigby, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5187 Us Route 60 E, Ste 11, Huntington, WV 25705 Phone: 304-399-5437 Fax: 304-399-1104 | |
Kate M. Waldeck, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 | |
Sherrie N Miranda, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1600 Medical Center Dr, Suite 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Jessie Shields, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr, Sutie 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Jackie R Stines Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Drive, Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Dr. Rose Mary Ayoob, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Jennifer K Gerlach, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr, Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 |