Provider Demographics
NPI:1043269574
Name:PARKER, WILEY A (MD)
Entity Type:Individual
Prefix:
First Name:WILEY
Middle Name:A
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5669 PEACHTREE DUNWOODY RD N
Mailing Address - Street 2:STE 295
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-256-9822
Mailing Address - Fax:404-256-0250
Practice Address - Street 1:5669 PEACHTREE DUNWOODY RD N
Practice Address - Street 2:STE 295
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-256-9822
Practice Address - Fax:404-256-0250
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2012-06-27
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Provider Licenses
StateLicense IDTaxonomies
GA015499207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D40810Medicare UPIN