JOHN CREEDMORE WYATT M.D. NPI 1871584904

NPI Information

  • NPI: 1871584904
  • Provider Name: JOHN CREEDMORE WYATT, M.D.
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 529 N GALLOWAY AVE
    SUITE 16
    MESQUITE, TX
    ZIP 75149
  • Phone: (972) 216-4411

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NPI Details

John Creedmore Wyatt, M.D. is a diagnostic radiology radiology in Mesquite, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. John Creedmore Wyatt, M.D. NPI is 1871584904. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

529 N GALLOWAY AVE
SUITE 16
MESQUITE, TX
ZIP 75149-420
Phone: (972) 216-4411
Fax: (972) 216-7346

The enumeration date for this NPI number is 10/28/2005 and was last updated on 9/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyE6695TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
188R743MEDICARE ID-TYPE UNSPECIFIEDTEXAS
288R743OTHERTEXASBCBS
3C23818MEDICARE UPINTEXAS
4117996202MEDICAIDTEXAS
5B005OTHERTEXASCHAMPUS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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