Wylie, Wesley D

Wylie, Wesley D is an sole proprietor health care provider with primary practice located at 280 River Park Dr Suite 350, Provo UT 84604-5764. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wylie, Wesley D can be contacted via phone (801) 380-0432.

Contact Information

Primary practice address
280 River Park Dr Suite 350 Provo UT 84604-5764
Phone: (801) 380-0432
Fax: (801) 802-0108
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M-12076 Idaho
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 187190-1205 Utah

Profile Details

NPI number 1548215197
LBN Legal business name Wylie, Wesley D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2006
Last updated Sep 28th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548215197 NPPES
Utah MEDICAID 11032

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