Wiley, Jerry William

Wiley, Jerry William is an sole proprietor health care provider with primary practice located at 1801 Glendale Dr Sw , Wilson NC 27893-4401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wiley, Jerry William can be contacted via phone (252) 237-3141.

Contact Information

Primary practice address
1801 Glendale Dr Sw Wilson NC 27893-4401
Phone: (252) 237-3141
Fax: (252) 293-8301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 21616 North Carolina

Profile Details

NPI number 1457496747
LBN Legal business name Wiley, Jerry William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2007
Last updated Jul 9th, 2007 - about 19 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 1457496747 NPPES
North Carolina MEDICAID 8913656
North Carolina Other 13656

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