Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 2144 | AZ |
NPI | 1134210768 |
---|---|
Provider Name | Scott Thomas Wiley |
First Address | Arcadia, CA 91066-0969 |
Second Address | Yuma, AZ 85364 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 24/08/2018 |