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Individual
THOMAS E WILEY III
Active
Individual
THOMAS E WILEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24695
OK
2085R0204X
Vascular & Interventional Radiology Physician
Primary
24695
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200068060A
—
OK
01
—
244534203
MEDICARE
OK
01
—
P00300599
RAILROAD MEDICARE
OK
Enumeration date
05/23/2006
Last updated
11/21/2023
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