Provider Demographics
NPI:1669730933
Name:DAILEY, WESLEY AARON (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:AARON
Last Name:DAILEY
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 26067
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84126-0067
Mailing Address - Country:US
Mailing Address - Phone:239-624-0390
Mailing Address - Fax:239-624-0391
Practice Address - Street 1:1726 MEDICAL BLVD STE 203
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1426
Practice Address - Country:US
Practice Address - Phone:239-624-0390
Practice Address - Fax:239-624-0391
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119242208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021356700Medicaid
FLQ86TSOtherBCBS
FLJA345ZOtherMEDICARE