Wynn, John R
Wynn, John R is an individual health care provider with primary practice located at 171 N 400 W C-12, Orem UT 84057-1909. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wynn, John R can be contacted via phone (801) 224-4550.Contact Information
Primary practice address
171 N 400 W C-12
Orem UT 84057-1909
Phone: (801) 224-4550
Fax: (801) 224-1057
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2746431205 | Utah |
Profile Details
| NPI number | 1255308102 |
|---|---|
| LBN Legal business name | Wynn, John R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | Jun 26th, 2019 - 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 | 1255308102 | NPPES |
| Utah | MEDICAID | DO483 |
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