Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jill Mallory Fadal Wilson, MD

Individual provider Diagnostic Radiology Physician · NPI 1275928897

Jill Mallory Fadal Wilson, MD is a Diagnostic Radiology in Park City, Utah. Graduated from Texas Tech University Health Science Center School of Medicine in 2015, 11 years ago. Practices with Fort Collins Radiologic Associates PC, a 65-clinician group and accepts Medicare assignment. Licensed in Colorado, Nebraska, Utah and Wyoming.

Years since qualifying
11
Trained at
Texas Tech University Health Science Center School of Medicine
Licensed in
CO, NE, UT, WY
In the registry since
2015
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1389 Center Dr Ste 200
Park City, UT 84098-7660
Phone: (970) 484-4757
Fax: (970) 484-4759
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 10964555-1205 (UT)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 15751A (WY)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence DR.0070579 (CO)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 35561 (NE)

Record details

NPI number1275928897
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2015
Last updated in NPPESMarch 4, 2024
Certification dateMarch 4, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolTEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Fort Collins Radiologic Associates Pc — 65 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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