Edward Henry Tiley III, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

12774 Issued in WV

Practice address

9 Courtney Dr
Charleston, WV 25304-2699

Phone

(304) 925-3115

Fax

(304) 925-2088

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1063510956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 COURTNEY DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042699",
            "telephone_number": "304-925-3115",
            "fax_number": "304-925-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 COURTNEY DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042699",
            "telephone_number": "304-925-3115",
            "fax_number": "304-925-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILEY",
        "first_name": "EDWARD",
        "middle_name": "HENRY",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WV",
            "license": "12774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128612000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Rose V Tigas, MD
• Shani Lauren Tighe
• Becky Tignor
• Lisha Tignor, ED.S.
• Whitney Necessary Tignor, PHARMD
• Chelsea Tiller
• Kayla Tiller
• Nichole Michelle Tillett
• Brittney Tilley
• Kimberly Tilley, MA

• Vascular Surgery Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Vascular Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.