Provider Demographics
NPI:1598772204
Name:WILES, MARK CAREY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CAREY
Last Name:WILES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 MEMORIAL HOSPITAL DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1787
Mailing Address - Country:US
Mailing Address - Phone:251-414-5900
Mailing Address - Fax:251-281-1162
Practice Address - Street 1:101 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1786
Practice Address - Country:US
Practice Address - Phone:251-414-5900
Practice Address - Fax:251-281-1167
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-05-18
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Provider Licenses
StateLicense IDTaxonomies
AL0013528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510I080123OtherMEDICARE PTAN
ALC72904Medicare UPIN
AL19606Medicare ID - Type Unspecified