Provider Demographics
NPI:1780701003
Name:WILSON, KEVIN F (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:F
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:96 E KIMBALLS LN
Mailing Address - Street 2:STE 309
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5021
Mailing Address - Country:US
Mailing Address - Phone:801-260-3687
Mailing Address - Fax:801-260-3688
Practice Address - Street 1:96 E KIMBALLS LN
Practice Address - Street 2:STE 309
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5021
Practice Address - Country:US
Practice Address - Phone:801-260-3687
Practice Address - Fax:801-260-3688
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7577039-1205207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology