Individual
DALTON H WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W, SUITE 112, PROVO, UT 84604-3305
(801) 812-4624
(801) 812-4699
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
174359-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107007673103
IHC
UT
01
—
16-00694
UNITED HEALTHCARE
UT
01
—
219637
ALTIUS
UT
01
—
79184
PEHP
UT
05
—
870281028000
—
UT
01
—
P00132863
PALMETTO GBA
—
Enumeration date
06/20/2006
Last updated
11/27/2023
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