Individual
WILLIAM BAXTER WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
052855
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
052855
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
655310012A FT. V-B
—
GA
05
—
655310012C
—
GA
Enumeration date
04/25/2006
Last updated
08/14/2012
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