Individual
PHILLIP EGBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
324 10TH AVE STE 154, SALT LAKE CITY, UT 84103-2876
(801) 408-8500
Mailing address
324 10TH AVE STE 154, SALT LAKE CITY, UT 84103-2876
(801) 408-8500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7471471-1205
UT
Other
Enumeration date
11/05/2008
Last updated
06/13/2012
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