DR. JOHN W. WYLLIE III (NPI# 1831171180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831171180 |
| Entity Type | Individual |
| Full Name | DR. JOHN W. WYLLIE III |
| Credential | M.D. |
| Practice Address |
456 Suite C Market Place Mall Weston WV 26452 |
| Practice Telephone | 3045171401 |
| Practice Fax Number | 3045171404 |
| Mailing Telephone | 3045171401 |
| Mailing Fax Number | 3045171404 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2020-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 36803 | KY | Allopathic & Osteopathic Physicians |
| Y | 207Y00000X | Otolaryngology | 23086 | WV | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 35084546 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810011846 | 05 | |
| OH | L2496384 | 05 |
| Street Address |
456 SUITE C MARKET PLACE MALL |
| City | WESTON |
| State | WV |
| Zip Code | 26452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437462017 | Diana Leigh Daugherty | Audiologist | 456 Suite C Market Place Mall, Weston, WV 26452 | 2010-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547136 | Sara Knotts | Technician | 102 Upper St, Weston, WV 26452 | 2020-10-30 |
| 1003414301 | Sarah Bowman | Technician | 55 4b Mobile Estates, Weston, WV 26452 | 2020-10-09 |
| 1962019752 | Victoria Louise Riggs | Pharmacist | 250 Court Street, Weston, WV 26452 | 2020-09-26 |
| 1710472188 | Brandi Nicole Miller | Occupational Therapist | 150 John St Ste C, Weston, WV 26452 | 2018-06-27 |
| 1184022428 | Community Care of West Virginia, Inc. | Pharmacy | 107 Staunton Dr, Weston, WV 26452 | 2014-12-19 |
| 1073944658 | Community Care of West Virginia, Inc. | Clinic/Center | 149 Staunton Drive, Weston, WV 26452 | 2013-12-06 |
| 1033452552 | Julie Ann Haddix | Nurse Practitioner | 29 Hospital Plz Ste E, Weston, WV 26452 | 2013-04-03 |
| 1972605608 | Phillip Mansfield Spaur | Chiropractor | 346 East 3rd Street, Weston, WV 26452 | 2006-09-02 |
| 1003918202 | Bio-medical Applications of West Virginia, Inc. | Clinic/Center | Market Place Plaza, Suite1c, Weston, WV 26452 | 2006-09-01 |
| 1093825432 | Khalid Mahmoud | Internal Medicine | 66 Hospital Plaza Suite 104, Weston, WV 26452 | 2006-08-30 |
| Find all providers in zip 26452 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407856222 | Jonathan D Cooper | Otolaryngology | 2500 Weston Rd, Suite 103, Weston, FL 33331-3615 | 2005-07-22 |
| 1972500718 | William J Moran | Otolaryngology | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2005-07-07 |
| 1114217478 | Travis Lewis | Otolaryngology | 2500 Weston Rd, Suite 103, Weston, FL 33331-3615 | 2011-04-07 |
| 1649407925 | Laura Marie Dominguez | Otolaryngology | 2950 Cleveland Clinic Blvd, Weston, FL 33331-3609 | 2009-06-15 |
| 1750525614 | Adam Seth Weisstuch | Otolaryngology | 2500 Weston Rd, Suite 103, Weston, FL 33331-3615 | 2009-04-22 |
| 1093979783 | Michael V Medina IIi | Otolaryngology | 2950 Cleveland Clinic Blvd, Weston, FL 33331-3609 | 2008-07-11 |
| 1093813834 | J Gerard Macdonald | Otolaryngology | 3501 Cranberry Blvd, Weston, WI 54476 | 2006-09-20 |
| 1538120779 | Gilberto O Alemar | Otolaryngology | 2950 Cleveland Clinic Blvd, Weston, FL 33331-3609 | 2006-03-29 |
| 1619937216 | Eloy Villasuso IIi | Otolaryngology | 2950 Cleveland Clinic Blvd, Weston, FL 33331-3609 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861781510 | Christopher Eric Bailey | Otolaryngology | 1 Medical Center Drive, Room 4520, Box 9200, Morgantown, WV 26506-9200 | 2011-04-04 |
| 1336349109 | Tanya Fancy | Otolaryngology | Room 4520, Hsc South, Morgantown, WV 26506-9200 | 2007-07-20 |
| 1649477662 | Sohrab Shahab | Otolaryngology | 2000 Foundation Way Ste 3200, Martinsburg, WV 25401-9199 | 2007-07-02 |
| 1245329705 | Garrison V. Morin Dba Mountain State Ent Center | Otolaryngology | 321 Lutz Ave, Suite A, Martinsburg, WV 25404-6362 | 2006-10-12 |
| 1235233784 | Raymond A Hinerman | Otolaryngology | 30 Medical Park Ste 223, Wheeling, WV 26003-6391 | 2006-09-12 |
| 1023120441 | Robert William Azar | Otolaryngology | 1801 Grand Central Ave, Vienna, WV 26105 | 2006-08-31 |
| 1740238765 | Prudencio C Corro | Otolaryngology | 673 Ritter Dr, Glen Morgan, WV 25813-7707 | 2006-05-04 |
| 1013984525 | Mark F Sheridan | Otolaryngology | #3 Stonecrest Dr, Huntington, WV 25701 | 2006-03-02 |
| 1619944477 | Phillip R Stevens | Otolaryngology | #3 Stonecrest Drive, Huntington, WV 25701 | 2006-03-01 |
| 1306817689 | Christopher L White | Otolaryngology | 231 Dawkins Dr, Lewisburg, WV 24901-9674 | 2006-01-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.