Individual provider · Type 1 NPI
Jill Mallory Fadal Wilson, MD
Diagnostic Radiology Physician · Park City, UT
NPI number
1275928897
Active
Practice location
1389 Center Dr Ste 200
Park City, UT 84098-7660
Fax (970) 484-4759
Mailing address
2008 Caribou Dr
Fort Collins, CO 80525-4325
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 15751A (WY) |
| Diagnostic Radiology Physician | 2085R0202X | DR.0070579 (CO) |
| Diagnostic Radiology Physician Primary | 2085R0202X | 10964555-1205 (UT) |
| Diagnostic Radiology Physician | 2085R0202X | 35561 (NE) |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
2 other providers at this address
Other diagnostic radiology physician providers in Park City
About NPI 1275928897
Jill Mallory Fadal Wilson, MD's National Provider Identifier is 1275928897, issued on Mar 31, 2015. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Park City, UT. The record was last updated on Mar 4, 2024.