Carl Thayne Wilson MD

NPI 1073608659 - Anesthesiology - 207L00000X

NPI Details
NPI 1073608659
Gender Male
Enumeration Date 10/03/2006
Last Updated 10/15/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
1034 NORTH 500 WEST
UTAH VALLEY REGIONAL MEDICAL CENTER
PROVO UT, 84604, US
Phone (801) 507-5248
Fax (801) 733-5618
Business Location
3340 NORTH CENTER ST
#800
LEHI UT, 84043-7406, US
Phone (801) 990-1911
Fax (801) 990-1912
Toxanomy
Taxonomy Code 207L00000X
License State Utah
License Number 88-179937-1205
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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.