Individual
DR. WYATT HARDING HORSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 ROUND VALLEY DR STE 110, PARK CITY, UT 84060-7552
(435) 333-3535
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01076865A
IN
207Q00000X
Family Medicine Physician
Primary
12777035-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08217507
ECFMG
—
05
—
201172500
—
IN
Enumeration date
04/30/2013
Last updated
06/20/2024
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