Individual
MARK E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2055 N MAIN ST, TOOELE, UT 84074-9819
(435) 843-3600
Mailing address
9895 EDEN CREST RD, SOUTH JORDAN, UT 84095-3011
(801) 254-6169
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3110304406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000061222
MEDICARE PTAN
UT
Enumeration date
07/27/2006
Last updated
12/07/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us