Individual
GENNIFER N. WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2550 WINDY HILL RD SE, SUITE 302, MARIETTA, GA 30067-8665
(678) 574-0943
(678) 574-0943
Mailing address
3155 N POINT PKWY, ATTN: CREDENTIALING DEPT, BUILDING F, SUITE 100, ALPHARETTA, GA 30005
(770) 645-9181
(770) 645-8455
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47277
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000825437H
—
GA
05
—
000825437I
—
GA
05
—
000825437J
—
GA
05
—
000825437K
—
GA
05
—
000825437L
—
GA
05
—
000825437M
—
GA
Enumeration date
10/05/2005
Last updated
08/12/2008
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