DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JILL MALLORY FADAL WILSON, M.D.

Active

JILL MALLORY FADAL WILSON, M.D. is a Diagnostic Radiology healthcare provider located in PARK CITY, Utah. NPI 1275928897 is currently active in the NPPES registry. Verify at CMS.

Diagnostic Radiology · PARK CITY, UT

Registration Details

NPI Number
1275928897
Provider Type
Individual
Gender
Female
NPI Issued
Mar 31, 2015 (11.392731727266 yrs)
Last Updated
Mar 4, 2024
Licenses
15751A (WY)
DR.0070579 (CO)
10964555-1205 (UT)
35561 (NE)

Practice Information

Address
1389 CENTER DR STE 200
PARK CITY, UT, 840987660
Browse UT providers · Browse ZIP 84098
Phone
9704844757
Fax
9704844759
Primary Specialty
Diagnostic Radiology
2085R0202X
Additional Specialty
Diagnostic Radiology
Additional Specialty
Diagnostic Radiology
Additional Specialty
Diagnostic Radiology

Other Diagnostic Radiology Providers in PARK CITY, UT

Name Credential NPI
JOHN MANUEL ARIAS MD 1649233214
WILLIAM RANDALL COMPTON M.D. 1629098637
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.