Individual
DOUGLAS E WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1032 E KARSCH BLVD, FARMINGTON, MO 63640-3403
(573) 701-9015
(573) 701-0103
Mailing address
1032 E KARSCH BLVD, FARMINGTON, MO 63640-3403
(573) 701-9015
(573) 701-0103
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2008-0010
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8215212
BC/BS OF IL
IL
Enumeration date
01/24/2008
Last updated
08/23/2013
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