Individual
WENDELL A GIBBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3152 N UNIVERSITY AVE, SUITE 100, PROVO, UT 84604-4729
(801) 229-2002
(801) 229-1003
Mailing address
3152 N UNIVERSITY AVE, SUITE 100, PROVO, UT 84604-4729
(801) 229-2002
(801) 229-1003
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
178394-1204
UT
Other
Enumeration date
09/20/2006
Last updated
04/23/2020
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