Philip Richard Wyatt, M.D.

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

21374 Issued in KY

Practice address

3101 Old Pecos TRL
Santa Fe, NM 87505-9025

Phone

(505) 438-2211

Fax

(505) 438-2220

NPI assigned

May 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982819199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 OLD PECOS TRL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875059025",
            "telephone_number": "505-438-2211",
            "fax_number": "505-438-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 OLD PECOS TRL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875059025",
            "telephone_number": "505-438-2211",
            "fax_number": "505-438-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "PHILIP",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "KY",
            "license": "21374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cori Alison Wright, MS, LMHC, SEP
• Ladonna Wright
• Mel Wright
• Rebecca M. Wright, MA LPCC
• Tahoma Wrubleski
• Christopher Robert Charles Wyndham, MD
• Andrea Leigh Wynn
• Kathryn Susanne Wynne, DDS
• Ying Xiong, CRNA
• Alyson Yacono, DPT, PT, CERT. DN

• Ph.D. Medical Genetics in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Ph.D. Medical Genetics in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.