National Provider Identifier Database

KELLY R WILEY, BS MLS (ASCP) – NPI #1144530544
Medical Technologist


Contact Information

KELLY R WILEY, BS MLS (ASCP)
3200 CANYON LAKE DR
RAPID CITY, SD57702-8114
Phone: 605-355-2229
Fax: 605-355-2514
Website:
Specialty Taxonomy Code
* Medical Technologist 246QM0706X

* Indicates primary specialty

NPI Profile & details for KELLY R WILEY

NPI Number 1144530544
Credentials BS MLS (ASCP)
Entity Individual
Enumeration date 10/19/2010
Last updated 10/19/2010 - About 16 years ago
Sole proprietor1 No
Identifiers
  • License #: 25324986
  • SD Medicaid: 0140070
  • SD Other: 5549050 MEDICAID
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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