Provider Demographics
NPI:1669906434
Name:KORLEY, WITHNEY MILORD (OD)
Entity type:Individual
Prefix:
First Name:WITHNEY
Middle Name:MILORD
Last Name:KORLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 PETERSON RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8953
Mailing Address - Country:US
Mailing Address - Phone:302-609-0041
Mailing Address - Fax:
Practice Address - Street 1:5435 PETERSON RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8953
Practice Address - Country:US
Practice Address - Phone:302-272-5517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003760152W00000X
FLOPC5543152W00000X
DEI3-0001418152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist