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NPI Code Detail

MEDICARE: CASIE WILEY MD, MPH

MEDICARE: CASIE WILEY MD, MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician55416KY

General Provider Information

NPI Number : 1235617275
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASIE WILEY MD, MPH
Provider Business Mailing Address
First Line : PO BOX 635283
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-5283
Country : US
Telephone Number : 859-344-5555
Fax Number : 859-344-5552
Provider Business Practice Location Address
First Line : 200 WEST 3RD STREET
Second Line :
City : NEWPORT
State : KY
Zip : 41071-1814
Country : US
Telephone Number : 859-578-5662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2018
Last Update Date : 07/11/2024

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