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Contact Information

DIRK T WILSON
4401 HARRISON BLVD
OGDEN, UT84403-3195
 Phone: 801-387-3364
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for DIRK T WILSON · (Male)

NPI Number 1184365413
Status Active
Credentials
Entity Individual
Enumeration date 04/01/2022
Last updated 05/22/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • UT License # 14211531-1204
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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