Provider Demographics
NPI:1386643765
Name:WILEY, THOMAS M (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:WILEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:DEPT CH 14389
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-4389
Mailing Address - Country:US
Mailing Address - Phone:785-295-8108
Mailing Address - Fax:785-231-5991
Practice Address - Street 1:634 SW MULVANE ST
Practice Address - Street 2:SUITE 209
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1678
Practice Address - Country:US
Practice Address - Phone:785-295-5330
Practice Address - Fax:785-295-5355
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2013-03-27
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Provider Licenses
StateLicense IDTaxonomies
KS422308207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSE45712OtherUPIN