DR. BRUCE WILEY (NPI# 1790823185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790823185 |
| Entity Type | Individual |
| Full Name | DR. BRUCE WILEY |
| Credential | M.D. |
| Practice Address |
4105 Kirkman St Lake Charles LA 70607-4603 |
| Mailing Address |
278 Hampton Ct Lake Charles LA 70605-6586 |
| Practice Telephone | 3374758022 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
10780R | LA | Allopathic & Osteopathic Physicians |
| Street Address |
4105 KIRKMAN ST |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70607-4603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578517439 | Craig D. Waggoner | Psychologist | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2006-05-22 |
| 1659988343 | Katie Bruce | Pharmacist | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2020-09-26 |
| 1598245623 | Imperial Calcasieu Human Services Authority | Clinic/Center | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2018-08-17 |
| 1730698838 | Rebecca Becky Perry | Social Worker | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2017-09-21 |
| 1538566336 | Troy Barrow | Registered Nurse | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-11-24 |
| 1992101240 | Clint Dupre | Licensed Practical Nurse | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-11-14 |
| 1386057891 | Vicki Ann Lebleu | Nurse Practitioner | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-06-03 |
| 1750792248 | Genoa Healthcare, LLC | Pharmacy | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2014-05-19 |
| 1376971200 | Lexi Berryhill | Social Worker | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2013-11-01 |
| 1700127487 | Dana Young | Counselor | 4105 Kirkman St, Lake Charles, LA 70607-4603 | 2013-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710596283 | Dakota Loosemore | Student in an Organized Health Care Education/Training Program | 800 East Mcneese Street, Lake Charles, LA 70607 | 2020-07-30 |
| 1467003822 | Sarah Jane Walley | Specialist/Technologist | 800 E Mcneese Street, Lake Charles, LA 70607 | 2019-09-26 |
| 1770053902 | Antonio Rivera | Chiropractor | 2625 Dillard Loop, Suite C, Lake Charles, LA 70607 | 2018-11-30 |
| 1851861330 | Shannon Marie Melvin | Specialist/Technologist | 800 East Mcneese, Lake Charles, LA 70607 | 2018-11-28 |
| 1326517699 | Vincent Michael Williams | Specialist/Technologist | 800 East Mcneese St, Lake Charles, LA 70607 | 2018-11-16 |
| 1396263356 | Lake Area Physician Services LLC | Durable Medical Equipment & Medical Supplies | 10071 Hwy 385, Lake Charles, LA 70607 | 2017-08-30 |
| 1023556370 | Heath Bryan Coleman, Dds of Louisiana II, A Professional Dental LLC | Dentist | 2625 Dillard Loop, Ste A, Lake Charles, LA 70607 | 2017-02-07 |
| 1750741880 | Townsend Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 635a Petro Point Dr, Lake Charles, LA 70607 | 2016-03-02 |
| 1194081414 | Clint Nickolas Lincoln | Family Medicine | 10071 Gulf Hwy, Lake Charles, LA 70607 | 2012-04-11 |
| 1295976652 | John Leroy Speer | Dentist | 3425 Louisiana Ave., Lake Charles, LA 70607 | 2009-03-16 |
| Find all providers in zip 70607 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255941902 | New Leaf Behavioral Health Clinicians, LLC | Psychiatry & Neurology | 2905 Fiske Street, Lake Charles, LA 70601-8550 | 2020-08-07 |
| 1801349238 | Access Serenity of Mississippi LLC | Psychiatry & Neurology | 4815 Ihles Rd, Lake Charles, LA 70605-5900 | 2016-08-02 |
| 1316203243 | Murphy Cantu Psychiatry Group LLC | Psychiatry & Neurology | 4501 Autumnwood Ln, Lake Charles, LA 70605-5453 | 2012-04-04 |
| 1679602932 | Said Cantu | Psychiatry & Neurology | 2829 4th Avenue, Lake Charles, LA 70601 | 2007-03-05 |
| 1336249762 | Ramin Shahla | Psychiatry & Neurology | 2837 Ernest Street, Calcacien Oak Hospital, Lake Charles, LA 70601 | 2006-09-25 |
| 1518071802 | Horatio Millin | Psychiatry & Neurology | 977 Baywood Dr, Lake Charles, LA 70611 | 2006-08-17 |
| 1073548756 | Paul Keith Nabours | Psychiatry & Neurology | 3700 5th Ave, Lake Charles, LA 70607-2134 | 2006-07-11 |
| 1760464796 | Charles A Murphy IIi | Psychiatry & Neurology | 2829 4th Ave, 150, Lake Charles, LA 70601-7887 | 2005-11-16 |
| 1326020330 | Ehtesham U Syed | Psychiatry & Neurology | 324 W Hale St, Lake Charles, LA 70601-8439 | 2005-11-16 |
| 1780685024 | Brian W Mooney | Psychiatry & Neurology | 100 S Ryan St, Lake Charles, LA 70601-5951 | 2005-08-09 |
| Find all providers in LAKE CHARLES | ||||
| City | LAKE CHARLES |
| Zip Code | 70607 |
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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.