Provider Demographics
NPI:1427008549
Name:RONEY, WESLEY B (MD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:B
Last Name:RONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1524
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1524
Mailing Address - Country:US
Mailing Address - Phone:800-841-4236
Mailing Address - Fax:706-596-6723
Practice Address - Street 1:2501 N PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1735
Practice Address - Country:US
Practice Address - Phone:229-443-1000
Practice Address - Fax:706-596-6723
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA799732085R0202X
KY325932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64325939Medicaid
GA003207222A-IMedicaid
KY64325939Medicaid
KY00046002Medicare PIN