Organization
EDWARD H. TILEY, III, M.D, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD H. TILEY III M.D. (OWNER)
(304) 925-3115
Entity
Organization
Contact information
Practice address
9 COURTNEY DR, CHARLESTON, WV 25304-2699
(304) 925-3115
(304) 925-2088
Mailing address
9 COURTNEY DR, CHARLESTON, WV 25304-2699
(304) 925-3115
(304) 925-2088
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12774
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128612000
—
WV
Enumeration date
04/18/2007
Last updated
11/13/2007
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