Edward H. Tiley, III, M.D, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12774 Issued in WV

Legal business name

EDWARD H. TILEY, III, M.D, INC.

Practice address

9 Courtney Dr
Charleston, WV 25304-2699

Phone

(304) 925-3115

Fax

(304) 925-2088

NPI assigned

Apr 18, 2007

Last updated

Nov 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward H. Tiley III, M.D.NPI 1063510956

Title

Owner

Phone

(304) 925-3115

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Henry Tiley III, M.D.

  • Vascular Surgery Physician
  • Charleston, WV
  • NPI 1063510956
  Authorized official Same address or phone
• Stacey Ellen Copeland, M.D.

  • Surgery Physician
  • Hannibal, MO
  • NPI 1861590770
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1962628743",
    "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": {
        "organization_name": "EDWARD H. TILEY, III, M.D, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "TILEY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-925-3115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "12774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128612000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Edgerton
• Edgewood Summit Inc
• Mona Edmonds
• Edmundo E. Figueroa, MD Inc
• Denise Edunueko
• Edward J. Grey, M.D.
• Abbagail Edwards
• Adrian Edwards
• Amy Snyder Edwards, LPC
• Averie Edwards

• Specialist in Charleston, WV
• Providers in Charleston, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.