Edward Henry Tiley III
Vascular Surgeon
9 Courtney Dr
Charleston
, West Virginia 25304-2699
Edward Henry Tiley III
Vascular Surgeon
9 Courtney Dr
Charleston
, West Virginia 25304-2699
(304) 925-2088
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Edward Henry Tiley III
- 9 Courtney Dr
- Charleston, WV
- Zip : 25304-2699
- Fax : (304) 925-2088
- Phone : (304) 925-3115
Second Address
- Edward Henry Tiley III
- 9 Courtney Dr
- Charleston, WV
- Zip : 25304-2699
- Fax : (304) 925-2088
- Phone : (304) 925-3115
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | 12774 | WV |
National Provider Identifier
| NPI | 1063510956 |
|---|---|
| Provider Name | Edward Henry Tiley III |
| First Address | Charleston, WV 25304-2699 |
| Second Address | Charleston, WV 25304-2699 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/09/2006 |
| Last Update Date | 23/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0128612000 | (05) | WV |
| A72223 | (02) | WV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.