Individual
DR. MARK EUGENE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
200 MARKET PL, RICHLAND, MS 39218-4429
(601) 420-2101
Mailing address
PO BOX 180369, RICHLAND, MS 39218-0369
(601) 397-0095
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
721
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00272896
—
MS
Enumeration date
05/23/2006
Last updated
02/20/2024
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