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:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548215197 | NPPES |
| Utah | MEDICAID | 11032 |
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