Wiley Roosth MD & Associates

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

B9174 Issued in TX

Legal business name

WILEY ROOSTH MD & ASSOCIATES

Practice address

1025 Hospital Dr
Tyler, TX 75701-2023

Phone

(903) 592-8181

Fax

(903) 592-8113

NPI assigned

Aug 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Wiley Roosth, M.D.

Title

Ceo

Phone

(903) 592-8181

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1104059955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 HOSPITAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012023",
            "telephone_number": "903-592-8181",
            "fax_number": "903-592-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 HOSPITAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012023",
            "telephone_number": "903-592-8181",
            "fax_number": "903-592-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILEY ROOSTH MD & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "ROOSTH",
        "authorized_official_first_name": "WILEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-592-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "B9174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030768801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilbea Medical Equipment LLC
• Donna C Wilcox
• Katarzyna Grazyna Wilczewska, PSY.D.
• Jennifer Wild, CRNA
• Julie Wilder, OT
• Kodi Wiley
• Holly Wilhelm
• Jerry D. Wilkerson, P.T.
• Matthew Harry Lee Wilkerson, M.D.
• Jessica Wilkin, M.D.

• Family Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.