Individual
WESLEY S MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
(435) 753-9521
Mailing address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
(435) 753-9521
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
351932-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336162924
—
UT
05
—
687920000
—
MN
Enumeration date
07/25/2006
Last updated
06/17/2026
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