NPI Details | |
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NPI | 1073608659 |
Gender | Male |
Enumeration Date | 10/03/2006 |
Last Updated | 10/15/2012 |
Entity Type | Individual |
Active | Over 11 years ago |
Practice Location | |
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1034 NORTH 500 WEST UTAH VALLEY REGIONAL MEDICAL CENTER PROVO UT, 84604, US |
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Phone | (801) 507-5248 |
Fax | (801) 733-5618 |
Business Location | |
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3340 NORTH CENTER ST #800 LEHI UT, 84043-7406, US |
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Phone | (801) 990-1911 |
Fax | (801) 990-1912 |
Toxanomy | |
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Taxonomy Code | 207L00000X |
License State | Utah |
License Number | 88-179937-1205 |
Remove 1073608659 NPI Number |
According to our database, Carl Thayne Wilson MD NPI is 1073608659, taxonomy code is 207L00000X and license number is 88-179937-1205, license state is located at Utah. Carl Thayne Wilson MD physically located at 1034 North 500 West, Provo UT, 84604. NPI Number Carl Thayne Wilson MD has the Individual type.
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1073608659 NPI number is provided on an as is basis without warranty of any kind. 1073608659 is maintained by the National Plan & Provider Enumeration System. The contents of Carl Thayne Wilson MD are for informational purposes only.
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