Organization
OHIO VALLEY COLON AND RECTAL SURGEONS PLLC
Active
Organization
OHIO VALLEY COLON AND RECTAL SURGEONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM STEVEN WILEY MD (PRACTICE OWNER)
(304) 238-0212
Entity
Organization
Contact information
Practice address
76 SIXTEENTH STREET, SUITE 100, WHEELING, WV 26003-3660
(304) 238-0212
(304) 238-0215
Mailing address
PO BOX 6493, WHEELING, WV 26003
(304) 238-0212
(304) 238-0215
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1806640000
—
WV
05
—
2289867
—
OH
Enumeration date
05/01/2007
Last updated
04/10/2012
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