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

Samuel M. Wilson, DO

Individual provider Dermatology Physician · NPI 1477865194

Samuel M. Wilson, DO is a Dermatology in Roosevelt, Utah. Graduated from Edward via Col of Osteo Medicine-Virginia Campus in 2010, 16 years ago. Practices with Uintah Basin Medical Center, a 60-clinician group and accepts Medicare assignment. Licensed in Utah and Washington.

Years since qualifying
16
Trained at
Edward via Col of Osteo Medicine-Virginia Campus
Licensed in
UT, WA
In the registry since
2010
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

210 W 300 N
Roosevelt, UT 84066-2336
Phone: (435) 722-4691
Fax: (435) 722-9291
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 5131797-1204 (UT)
Dermatology Physician Taxonomy 207N00000X · Licence OP60440339 (WA)

Record details

NPI number1477865194
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 10, 2010
Last updated in NPPESNovember 2, 2021
Certification dateNovember 2, 2021
Mailing address210 W 300 N, Roosevelt, UT 84066-2336

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolEDWARD VIA COL OF OSTEO MEDICINE-VIRGINIA CAMPUS
Graduated 2010 (16 years in practice)
Group practice Uintah Basin Medical Center — 60 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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