Dr. Clarence L Wiley Sr., M.D.,M.M.S.,F.A.A.D
Dermatology in Oklahoma City, OK. Individual provider (NPI-1).
NPI number1477564797
StatusActive
Last updated in NPPESAug 4, 2016
Details
- NPI
- 1477564797
- Entity type
- Individual (NPI-1)
- Name
- Dr. Clarence L Wiley Sr.
- Credential
- M.D.,M.M.S.,F.A.A.D
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 11, 2006
- Last updated
- Aug 4, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 12980 | OK | Yes |
Other names
- Clarence Lapierce Wiley (Professional Name)
Practice location
1211 N Shartel Ave Ste 407Oklahoma City, OK 73103-2425
Phone 405-278-7911 · Fax 405-278-7925
Mailing address
Po Box 2074Lowell, AR 72745-2074
Phone 405-278-7911 · Fax 405-278-7925
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