Provider Demographics
NPI:1568574457
Name:RILEY, ANGELA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:RILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1210 OFFICE PARK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-3606
Mailing Address - Country:US
Mailing Address - Phone:662-232-2786
Mailing Address - Fax:662-232-2443
Practice Address - Street 1:1210 OFFICE PARK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-3606
Practice Address - Country:US
Practice Address - Phone:662-232-2786
Practice Address - Fax:662-232-2443
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20152207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology