G Sam Wilson MD PC

NPI #1962521120 in Bountiful, Utah

Provider Information

NPI Number: 1962521120
Entity Type: Organization
Organization Name: G Sam Wilson MD PC
Primary Specialty: Specialist
Enumeration Date: Mar 28, 2007
Last Updated: Nov 19, 2007

Practice Location

Address: 440 MEDICAL DR
City: Bountiful
State: Utah
ZIP Code: 84010-4950
Phone: (801) 298-9100

Authorized Official

Name: G. SAM WILSON, M.D.
Title: PROVIDER
Phone: (801) 298-9100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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