Individual
PHILIP KICKLITER WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4704 WHITESBURG DR SW STE 200, HUNTSVILLE, AL 35802
(256) 880-4510
(256) 880-4512
Mailing address
4704 WHITESBURG DR SW STE 200, HUNTSVILLE, AL 35802-1681
(256) 533-7064
(256) 704-0115
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.30722
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158112000
—
MN
Enumeration date
03/27/2007
Last updated
08/14/2018
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