Individual
WESLEY D WYLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 RIVER PARK DR, SUITE 350, PROVO, UT 84604-5764
(801) 380-0432
(801) 802-0108
Mailing address
1027 OAKRIDGE RD S, PARK CITY, UT 84098-5615
(801) 380-0432
(801) 802-0108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
187190-1205
UT
207Q00000X
Family Medicine Physician
Primary
M-12076
ID
208M00000X
Hospitalist Physician
M-12076
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11032
—
UT
Enumeration date
05/23/2006
Last updated
12/09/2024
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