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Dr. Darryl Neal Willett, MD

(Dr. Darryl Willett, MD)

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Specializes in: Facial Plastic Surgery and Otolaryngology (Ear, Nose, and Throat)

Ohio State University College of Medicine (1991)

Professional interests include: throat problems, thyroid surgery, ear problems, and more.

974 Bethel Road
Ste A Columbus, OH 43214

(614) 273-2230

Dr. Darryl Neal Willett, MD is a facial plastic surgeon in Westerville, OH specializing in facial plastic surgery and otolaryngology (ear, nose, and throat). He graduated from Ohio State University College of Medicine in 1991 and has 35 years of experience. Dr. Darryl Neal Willett, MD is affiliated with Mount Carmel Health System and Ohio Health.

Office Locations

Ohio Health

477 Cooper Road Suite 480
Westerville, OH 43081

(614) 538-2424

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Mount Carmel Health System

974 Bethel Road
Ste A Columbus, OH 43214

(614) 273-2230

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Ohio Health

974 Bethel Road Suite A
Columbus, OH 43214

(614) 273-2230

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Some issues Dr. Darryl Neal Willett, MD can help you with:

Thyroid Problems

Thyroid problems are a group of conditions that alter hormone regulation and metabolism. The thyroid is a small, butterfly-shaped gland located in the lower neck, just below the Adam's apple (laryngeal prominence) and larynx (voice box). Despite its small size, the thyroid has an outsized effect on the body by regulating hormones that control metabolism. Metabolism is the body's process of converting consumed food into fuel to power the entire body. Heart rate, weight, cholesterol, body temperature, and even physical growth and development are all affected by the metabolism.

When the thyroid malfunctions, the body is unable to properly process and allocate energy. Thyroid problems, such as hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid), cause irregular metabolism. In some cases, the body produces antibodies that attack the thyroid cells for unknown reasons. The damaged thyroid responds by releasing either too little or too much T3 and T4 thyroid hormones. Thyroid malfunctions may also arise from genetic causes or iodine deficiency. Thyroid problems may include:

Hashimoto's thyroiditis, an autoimmune disease that causes hypothyroidism
Graves' disease, an autoimmune disease that causes hyperthyroidism
Goiter
Thyroid nodule
Thyroid cancer

Hashimoto's is the leading cause of hypothyroidism, which is when the thyroid does not produce enough hormones to stimulate adequate metabolism. The condition is diagnosed by blood tests that measure TSH (thyroid stimulating hormone) and detect Hashimoto's antibodies. Symptoms of hypothyroidism include sluggish metabolism, inflammation, fatigue, weight gain, brittle hair, dry skin, and sensitivity to cold. To supplement impaired thyroid function, patients with Hashimoto's are typically prescribed synthetic thyroid hormone pills. Such patients may need to consume synthetic thyroids for the rest of their lives. Other treatments may include dietary changes, such as the avoidance of certain foods and medication to reduce inflammation. Frequent blood tests can inform patients if their TSH levels are within a normal range.

Grave's disease is most frequently the cause of hyperthyroidism, which is when the thyroid produces too many hormones, overstimulating one's metabolism. The condition is also diagnosed by blood tests that measure TSH and detect Grave's antibodies. Elevated heart rate, high blood pressure, sweating, bulging eyes, and weight loss are common symptoms of hyperthyroidism. Treatments for hyperthyroidism include oral radioactive iodine, which slowly shrinks the thyroid, slowing the production of excess thyroid hormone. Other anti-thyroid medications such as methimazole (Tapazole) also reduce the production of thyroid hormones. Blood pressure medications known as beta blockers can ease the increased heart rate caused by hyperthyroidism. If treatments are unsuccessful, patients may be prescribed a thyroidectomy, or surgery to remove part or all of the thyroid. Some patients with hyperthyroidism may require ophthalmological (eye medicine) treatments such as eye drops, prednisone, and surgery to reduce eye swelling and bulging.

Untreated thyroid disorders frequently lead to goiters or thyroid nodules. A thyroid goiter is a large lump that can be felt near the base of the neck and is made of swollen thyroid tissue or nodules (excess cell growth). Nodules and goiters are diagnosed by CT scan or ultrasound. Obstructive goiters can cause pain, coughing, and abnormal breathing. The most common cause of goiters is hyperthyroidism (overactive thyroid). However, Hashimoto's is also known to cause goiters or nodules. Goiters develop from continued damage from antibodies to the thyroid over time. At times, a goiter can result from a cancerous thyroid tumor. Most goiters and nodules are themselves benign.

The exact causes of thyroid cancer are unknown. People who develop thyroid cancer may or may not have another thyroid problem such as Hashimoto's or Grave's disease. Symptoms of thyroid cancer include a nodule that can be felt on the neck, hoarseness, difficulty swallowing, swelling in the neck, and neck and throat pain. CT and MRI scans are used to diagnose thyroid cancer. There are four types of thyroid cancer which vary in intensity. Thyroidectomy (thyroid removal surgery) is usually prescribed to treat thyroid cancer.

Thyroid problems are often long-term conditions that require some form of treatment. With regular monitoring and medication, many people with thyroid problems are able to lead active and fulfilling lives.

Thyroid Surgery

Thyroid surgery is a procedure to remove all or part of the thyroid gland. The thyroid is a small, butterfly-shaped gland in the lower neck that regulates the hormones that manage metabolism. Thyroid surgery, also known as thyroidectomy, treats thyroid disorders such as hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), goiters (noncancerous thyroid inflammation), and thyroid cancer. It may also be used to remove thyroid nodules or cysts that have a risk of becoming cancerous.

Both hypothyroidism and goiters are caused by an autoimmune reaction where the body produces antibodies that attack the thyroid cells for unknown reasons. The thyroid reacts by releasing too little or too much T3 and T4 thyroid hormones, impairing thyroid function and causing irregular metabolism. Goiters develop from the autoimmune reaction causing continued antibody damage to the thyroid over time. Thyroid goiters are large, swollen lumps that can be felt near the base of the neck. Obstructive goiters can cause pain, coughing, and abnormal breathing. Hypothyroidism may also be caused by iodine deficiency, as iodine is needed to produce thyroid hormones.

The exact cause of thyroid cancer and thyroid nodules or cysts is unknown. While thyroid cancer and thyroid nodules or cysts can occur in individuals with thyroid disorders, they are not associated with a malfunctioning thyroid.

Physicians may prescribe thyroid surgery if blood tests reveal patients' thyroid stimulating hormones (TSA) are outside of the acceptable range, indicating a malfunctioning thyroid. Thyroid biopsies (tissue samples) and tests for thyroid-attacking antibodies are also criteria for surgery.

An ENT or general surgeon performs thyroid surgery. While a patient is placed under anesthesia, the surgeon makes an incision at the center of the neck and removes the thyroid gland. Two alternative methods of thyroid surgery are transoral (incision through the mouth) and endoscopic, where a surgeon operates a video camera for live footage to help guide the removal process.

Thyroid surgery requires minimal aftercare. Most patients recover quickly and resume normal activities within a few days of surgery. However, thyroid surgery patients must take daily synthetic thyroid medication (levothyroxine) for life to replace their removed thyroid.

Noteworthy Medicare Patient Procedures Performed by Dr. Darryl Neal Willett, MD in 2023

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 5%

By Volume:

inpatient hospital care

In 2023, Dr. Darryl Neal Willett, MD performed more inpatient hospital care (for patient admitted to hospital) procedures for Medicare patients than 95% of providers in related specialties within Ohio.

Top 25%

By Affordability:

diagnostic flexible laryngoscopy

diagnostic laryngoscopy

fiberoptic laryngoscopy

flexible laryngoscopy

laryngeal procedures

laryngoscopy

In 2012, Dr. Darryl Neal Willett, MD had a list price for diagnostic flexible laryngoscopy, diagnostic laryngoscopy, fiberoptic laryngoscopy, flexible laryngoscopy, laryngeal (voice box) procedures, and laryngoscopy that was lower than the list prices billed to Medicare by 75% of providers in related specialties within Ohio. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2012 were immunotherapy, injections and stroboscopy.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	377
immunotherapy	50
injections	50
stroboscopy	24

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2013 were immunotherapy, injections, endocrine surgery and stroboscopy.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	353
endocrine surgery	26
immunotherapy	61
injections	61
neck surgery	14
stroboscopy	22

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	123
Female	192

**Ethnicity**
Non-Hispanic White	293
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	153
From 75 to 84	96
85 and over	40
Less than 65	26

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2013

Hypertension	65
High Cholesterol	59
Stroke	7
Ischemic Heart Disease	34
Depression	19
Chronic Kidney Disease	17
Asthma	9
Osteoperosis	13
Atrial Fibrilation	11
Heart Failure	15
Chronic Obstructive Pulmonary Disease	13
Diabetes	26
Dementia	5
Cancer	14

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2014 were immunotherapy, injections and stroboscopy.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	365
immunotherapy	61
injections	61
stroboscopy	17

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	128
Female	215

**Ethnicity**
Non-Hispanic White	321
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	168
From 75 to 84	102
85 and over	35
Less than 65	38

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2014

Hypertension	62
High Cholesterol	55
Stroke	6
Ischemic Heart Disease	33
Depression	23
Chronic Kidney Disease	19
Asthma	8
Osteoperosis	9
Atrial Fibrilation	10
Heart Failure	14
Chronic Obstructive Pulmonary Disease	13
Diabetes	27
Dementia	5
Cancer	10

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2015 were immunotherapy, injections, stroboscopy and hospital care.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

diagnostic evaluation	17
doctor visit	429
endocrine surgery	15
hospital care	19
immunotherapy	75
injections	75
inpatient care	19
neck surgery	15
stroboscopy	33

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	296
Female	480

**Ethnicity**
Non-Hispanic White	718
Black	36
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	386
From 75 to 84	226
85 and over	80
Less than 65	84

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2015

Hypertension	63
High Cholesterol	53
Stroke	9
Ischemic Heart Disease	31
Depression	23
Chronic Kidney Disease	20
Asthma	12
Osteoperosis	10
Atrial Fibrilation	14
Heart Failure	16
Chronic Obstructive Pulmonary Disease	13
Diabetes	27
Dementia	6
Cancer	10

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2016 were stroboscopy, diagnostic evaluation, endocrine surgery and hospital care.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

diagnostic evaluation	20
doctor visit	429
endocrine surgery	17
hospital care	17
inpatient care	17
stroboscopy	29

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	148
Female	230

**Ethnicity**
Non-Hispanic White	335
Black	22
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	195
From 75 to 84	113
85 and over	43
Less than 65	27

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2016

Hypertension	65
High Cholesterol	56
Stroke	7
Ischemic Heart Disease	32
Depression	26
Chronic Kidney Disease	24
Asthma	17
Osteoperosis	10
Atrial Fibrilation	12
Heart Failure	13
Chronic Obstructive Pulmonary Disease	13
Diabetes	26
Dementia	9
Cancer	9

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2017 were endocrine surgery, neck surgery, CT scan and hospital care.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

CT scan	12
doctor visit	458
endocrine surgery	14
hospital care	12
inpatient care	12
neck surgery	14

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	143
Female	226

**Ethnicity**
Non-Hispanic White	331
Black	21
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	184
From 75 to 84	114
85 and over	43
Less than 65	28

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2017

Hypertension	67
High Cholesterol	52
Stroke	4
Ischemic Heart Disease	32
Depression	30
Chronic Kidney Disease	26
Asthma	11
Osteoperosis	15
Atrial Fibrilation	12
Heart Failure	12
Chronic Obstructive Pulmonary Disease	15
Diabetes	26
Dementia	8
Cancer	11

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2018 were endocrine surgery, stroboscopy, immunotherapy and injections.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	465
endocrine surgery	24
hospital care	11
immunotherapy	13
injections	13
inpatient care	11
neck surgery	12
stroboscopy	16

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	155
Female	244

**Ethnicity**
Non-Hispanic White	356
Black	19
Hispanic	0
Asian	0
Other	13
Native American	0

**Age**
From 65 to 74	226
From 75 to 84	109
85 and over	46
Less than 65	18

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2018

Hypertension	66
High Cholesterol	58
Stroke	5
Ischemic Heart Disease	31
Depression	25
Chronic Kidney Disease	26
Asthma	11
Osteoperosis	12
Atrial Fibrilation	13
Heart Failure	12
Chronic Obstructive Pulmonary Disease	15
Diabetes	25
Dementia	5
Cancer	11

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2019 were immunotherapy, injections, hospital care and inpatient care.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

CT scan	11
doctor visit	456
hospital care	14
immunotherapy	15
injections	15
inpatient care	14
stroboscopy	12

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	166
Female	224

**Ethnicity**
Non-Hispanic White	349
Black	0
Hispanic	0
Asian	0
Other	19
Native American	0

**Age**
From 65 to 74	208
From 75 to 84	114
85 and over	45
Less than 65	23

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2019

Hypertension	65
High Cholesterol	60
Stroke	4
Ischemic Heart Disease	35
Depression	28
Chronic Kidney Disease	28
Asthma	9
Osteoperosis	14
Atrial Fibrilation	15
Heart Failure	14
Chronic Obstructive Pulmonary Disease	16
Diabetes	25
Dementia	7
Cancer	10

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2020 were endocrine surgery and neck surgery.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	351
endocrine surgery	12
neck surgery	12

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	127
Female	196

**Ethnicity**
Non-Hispanic White	291
Black	0
Hispanic	0
Asian	0
Other	15
Native American	0

**Age**
From 65 to 74	192
From 75 to 84	80
85 and over	35
Less than 65	16

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2020

Hypertension	60
High Cholesterol	52
Stroke	0
Ischemic Heart Disease	35
Depression	25
Chronic Kidney Disease	27
Asthma	11
Osteoperosis	11
Atrial Fibrilation	10
Heart Failure	13
Chronic Obstructive Pulmonary Disease	11
Diabetes	22
Dementia	6
Cancer	12

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2021 were endocrine surgery, minimally invasive procedures, laryngeal (voice box) procedures and neck surgery.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	381
endocrine surgery	29
hospital care	13
inpatient care	13
laryngeal (voice box) procedures	24
minimally invasive procedures	24
neck surgery	16

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	135
Female	195

**Ethnicity**
Non-Hispanic White	297
Black	0
Hispanic	0
Asian	0
Other	16
Native American	0

**Age**
From 65 to 74	177
From 75 to 84	100
85 and over	40
Less than 65	13

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2021

Hypertension	65
High Cholesterol	60
Stroke	5
Ischemic Heart Disease	33
Depression	27
Chronic Kidney Disease	30
Asthma	9
Osteoperosis	18
Atrial Fibrilation	10
Heart Failure	14
Chronic Obstructive Pulmonary Disease	10
Diabetes	28
Dementia	6
Cancer	14

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH during 2022 were endocrine surgery, minimally invasive procedures, laryngeal (voice box) procedures and neck surgery.

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

doctor visit	404
endocrine surgery	25
laryngeal (voice box) procedures	19
minimally invasive procedures	19
neck surgery	12

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	137
Female	207

**Ethnicity**
Non-Hispanic White	310
Black	16
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	181
From 75 to 84	116
85 and over	35
Less than 65	12

Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD in 2022

Hypertension	70
High Cholesterol	75
Stroke	7
Ischemic Heart Disease	30
Depression	26
Chronic Kidney Disease	20
Asthma	13
Osteoperosis	23
Atrial Fibrilation	17
Heart Failure	12
Chronic Obstructive Pulmonary Disease	17
Diabetes	27
Dementia	5
Cancer	17

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2022

Volume of procedures performed by Dr. Darryl Neal Willett, MD for Medicare patients.

The highest averages for the top procedures that Dr. Darryl Neal Willett, MD treated as a facial plastic surgeon in Westerville, OH were immunotherapy, injections, minimally invasive procedures and laryngeal (voice box) procedures.

CT scan	11
diagnostic evaluation	18
doctor visit	406
endocrine surgery	20
hospital care	14
immunotherapy	45
injections	45
inpatient care	14
laryngeal (voice box) procedures	21
minimally invasive procedures	21
neck surgery	13

Average Medicare Patient Data From 2012 - 2022

Information about Medicare patients treated by Dr. Darryl Neal Willett, MD.

**Gender**
Male	141
Female	219

**Ethnicity**
Black / African American	10
Asian / Pacific Islander	0
Non-Hispanic White	327
Native American / Alaskan Native	0
Hispanic	0
Other	5

**Age**
75 to 84	106
85 and over	40
Less than 65	25
65 to 74	188

Average of Total of Conditions of Medicare patients treated by Dr. Darryl Neal Willett, MD From 2012 - 2022

The highest averages of the most common conditions of Medicare patients that Dr. Darryl Neal Willett, MD treated were hypertension, high cholesterol, ischemic heart disease and depression.

Hypertension	58
High Cholesterol	52
Stroke	4
Ischemic Heart Disease	29
Depression	22
Chronic Kidney Disease	21
Asthma	10
Osteoporosis	12
Heart Failure	12
Chronic Obstructive Pulmonary Disease	12
Diabetes	23
Atrial Fibrillation	11
Dementia	5
Cancer	10

Education & Training

Dr. Darryl Neal Willett, MD graduated from Ohio State University College of Medicine in 1991. He completed residency at Ohio State University Medical Center. He is certified by the Ear, Nose, and Throat, Otolaryngology-Head and Neck Surgery, American Board and has a state license in Ohio.

Medical School: Ohio State University College of Medicine (1991)

Residency: Ohio State University Medical Center (1996)

Board Certification: Ear, Nose, and Throat, Otolaryngology-Head and Neck Surgery, American Board (1997)

Licensed In: Ohio

Affiliations & Hospitals

Dr. Darryl Neal Willett, MD is associated with these hospitals and organizations:

Mount Carmel Health System

Ohio Health

Ratings & Reviews

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General Payments

These charts describe general payments received by Dr. Darryl Neal Willett, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Shire North American Group Inc	$38 NATPARA $38
Mallinckrodt LLC	$38 XARTEMIS XR $38
Greer Laboratories, Inc.	$35 Oralair $35
Arbor Pharmaceuticals, Inc.	$34 Otovel $34
Mylan Specialty L.P.	$24 Dymista $12	EpiPen $12
Other	$135 Precision Energy Products for Head & Neck Surgical Applications $20	CAPRELSA $18	Dexilant $17	Dymista $16	ENTRE $14	Other $50

**Types of Payments**
Food and Beverage	$265
Education	$38

Biography

Dr. Darryl Willett specializes in facial plastic surgery and otolaryngology (ear, nose, and throat). Dr. Willett's areas of expertise include throat problems, thyroid problems, and thyroid surgery. He studied medicine at Ohio State University College of Medicine. He trained at Ohio State University Medical Center for residency. He is professionally affiliated with Grant Medical Center, Mount Carmel Health System, and Dublin Methodist Hospital. Dr. Willett has a closed panel according to Mount Carmel Health System.