Search › Utah › 207N00000X
Samuel Wilson, DO
NPI 1477865194 · on the registry since 2010
Practice
- Address
- 210 W 300 N
Roosevelt, UT 84066 - Phone
- (435) 722-4691
- Fax
- (435) 722-9291
- Organisation at this address
- Northeastern Utah Medical Group
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 17
Registry record
- Primary taxonomy
- 207N00000X
207N00000X
- Also registered as
- 207N00000X
- Licence states on file
- UT, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-11-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah