MEDICARE: DR. JAMES FRANKLIN WILEY OD

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
1	152W00000X	Optometrist	255	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0D255	OTHER		PROVIDER

General Provider Information

NPI Number	:	1780707026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES FRANKLIN WILEY OD

Provider Business Mailing Address
First Line	:	7430 E CHAPARRAL ROAD
Second Line	:	SUITE 130A
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85250-7113
Country	:	US
Telephone Number	:	480-945-8011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 W CHANDLER BLVD
Second Line	:	#13
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6175
Country	:	US
Telephone Number	:	480-726-9800
Fax Number	:	480-726-9802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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