Provider Demographics
NPI:1366761108
Name:WILEY, JULIE LOUISE (DO)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LOUISE
Last Name:WILEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:LOUISE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:535 NW 9TH ST
Mailing Address - Street 2:STE 220
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1070
Mailing Address - Country:US
Mailing Address - Phone:405-272-8498
Mailing Address - Fax:405-272-8425
Practice Address - Street 1:535 NW 9TH ST
Practice Address - Street 2:STE 220
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1070
Practice Address - Country:US
Practice Address - Phone:405-272-8498
Practice Address - Fax:405-272-8425
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5123207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology