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General NPI Number Information
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NPI Number | 1568574457
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Entity Type | Individual
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Provider Name | ANGELA M RILEY MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 1210 OFFICE PARK DR SUITE 102
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City | OXFORD
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State | MS
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Zip | 38655-3606
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Country | US
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Telephone | 662-232-2786
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Fax | 662-232-2443
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Provider Business Mailing Address
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Address Line | 1210 OFFICE PARK DR SUITE 102
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City | OXFORD
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State | MS
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Zip | 38655-3606
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Country | US
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Telephone | 662-232-2786
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Fax | 662-232-2443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 20152
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License Number State | MS
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