# CARL THAYNE WILSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073608659
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 88-179937-1205 | UT | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 10/15/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002089788 | — | NV |
| 01 | — | 107005544101 | IHC | UT |
| 05 | — | 119214100 | — | WY |
| 01 | — | 1502954 | UMWA | UT |
| 01 | — | 2090168 | UNITED HEALTHCARE | UT |
| 01 | — | 37038 | DESERET MUTUAL | UT |
| 01 | — | 37831 | PEHP | UT |
| 01 | — | 53282 | HEALTHY U | UT |
| 05 | — | 768046 | — | AZ |
| 05 | — | 806095300 | — | ID |
| 01 | — | 8597445 | WORKERS COMP | UT |
| 01 | — | 870545614WI1 | EDUCATORS MUTUAL | UT |
| 01 | — | QM0000075886 | ALTIUS | UT |
| 01 | — | TPRA07712 | MOLINA | UT |