# WESLEY SHAYNE BOTT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124503396
- **Authorized official:** WESLEY S BOTT (OWNER)
- **Authorized official phone:** (801) 798-7301

## Contact information

- **Practice address:** 238 E 400 S, PAYSON, UT 84651-5735
- **Practice address phone:** (801) 658-9094
- **Practice address fax:** (801) 658-9094
- **Mailing address:** 238 E 400 S, PAYSON, UT 84651-5735
- **Mailing address phone:** (801) 658-9094
- **Mailing address fax:** (801) 658-9094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2018
- **Last updated:** 02/25/2019