DR. Clarence L Wiley SR., M.D.,M.M.S.,F.A.A.D

NPI #1477564797 in Oklahoma City, Oklahoma

Provider Information

NPI Number: 1477564797
Entity Type: Individual
Name: DR. Clarence L Wiley SR., M.D.,M.M.S.,F.A.A.D
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dermatology
Credential: M.D.,M.M.S.,F.A.A.D
Enumeration Date: Aug 11, 2006
Last Updated: Aug 4, 2016

Practice Location

Address: 1211 N SHARTEL AVE STE 407
City: Oklahoma City
State: Oklahoma
ZIP Code: 73103-2425
Phone: (405) 278-7911

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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