Wiley, Clarence L

Wiley, Clarence L is an sole proprietor health care provider with primary practice located at 1211 N Shartel Ave Ste 407 , Oklahoma City OK 73103-2425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wiley, Clarence L can be contacted via phone (405) 278-7911.

Contact Information

Primary practice address
1211 N Shartel Ave Ste 407 Oklahoma City OK 73103-2425
Fax: (405) 278-7925
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 12980 Oklahoma

Profile Details

NPI number 1477564797
LBN Legal business name Wiley, Clarence L
Credentials M.D.,M.M.S.,F.A.A.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 11th, 2006
Last updated Aug 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477564797 NPPES
Oklahoma Other 243432400 MEDICARE

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