Organization
KENNETH L. WILEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WILEY M.D. (OWNER)
(504) 309-9140
Entity
Organization
Contact information
Practice address
3308 TULANE AVE STE 200, NEW ORLEANS, LA 70119-7100
(504) 309-9140
(504) 309-9317
Mailing address
3308 TULANE AVE STE 200, NEW ORLEANS, LA 70119-7100
(504) 309-9140
(504) 309-9317
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
09539R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1965669
—
LA
Enumeration date
07/17/2012
Last updated
07/17/2012
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