Individual
DR. MATTHEW ALLEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 N 500 E, LOGAN, UT 84341-2400
(435) 752-1693
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
7154791-1205
UT
Other
Enumeration date
11/05/2008
Last updated
04/11/2019
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