Marilyn B Wise
Medical Specialty
Professional ID
- NPI: 1720098189
- PECOS ID: 5698877066
- Enrollment ID: I20070305000062
- Credential(MD, DO, DPM): NP
- Medical School: University Of Utah School Of Medicine
- Medical School Graduation Year: 2006
Hospital Service
- Hospital CCN1: 460004
- Business Name (LBN)1: Mckay Dee Hospital
- Hospital CCN2: 460005
- Business Name (LBN)2: Ogden Regional Medical Center
Medical Practices
- Organization Name: Tanner Memorial Clinic
- Group Practice ID assigned by PECOS: 4284547985
- Number of Group Practice member: 111
Location
- Address1: 2121 N 1700
- Address2: Tanner Clinic
- City: Layton
- State: Utah
- Zip Code: 84041
- Phone Number: (801)773-4840
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR):