Provider Demographics
NPI:1992996292
Name:GILES, WESLEY HEATH (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:HEATH
Last Name:GILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:979 E 3RD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2187
Mailing Address - Country:US
Mailing Address - Phone:423-267-0466
Mailing Address - Fax:423-757-0770
Practice Address - Street 1:979 E 3RD ST STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2187
Practice Address - Country:US
Practice Address - Phone:423-267-0466
Practice Address - Fax:423-757-0770
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD44344208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003124054AMedicaid
6729863OtherCIGNA
TN4325181OtherBCBS
TN1510680Medicaid
TNMD44344OtherTN MEDICAL LICNESE
103I931431Medicare PIN