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General NPI Number Information
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NPI Number | 1659322899
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Entity Type | Individual
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Provider Name | MARK A WILEY MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 4000 CAMBRIDGE STREET STE G600
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City | KANSAS CITY
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State | KS
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Zip | 66160-8501
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Country | US
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Telephone | 913-588-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 CAMBRIDGE ST STE G600
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City | KANSAS CITY
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State | KS
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Zip | 66160-8501
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Country | US
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Telephone | 913-588-9600
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2005023743
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 04-29533
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 2005023743
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 04-29533
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License Number State | KS
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