Wilson, Jill Mallory Fadal

Wilson, Jill Mallory Fadal is an individual health care provider with primary practice located at 1389 Center Dr Ste 200 , Park City UT 84098-7660. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Wilson, Jill Mallory Fadal can be contacted via phone (970) 484-4757.

Contact Information

Primary practice address
1389 Center Dr Ste 200 Park City UT 84098-7660
Phone: (970) 484-4757
Fax: (970) 484-4759
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 15751A Wyoming
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X DR.0070579 Colorado
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 10964555-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 35561 Nebraska

Profile Details

NPI number 1275928897
LBN Legal business name Wilson, Jill Mallory Fadal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2015
Last updated Mar 4th, 2024 - about 6 months 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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