Healthcare Provider Details

I. General information

NPI: 1881500718
Provider Name (Legal Business Name): OUTPOST HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 S 200 W
BLANDING UT
84511-3910
US

IV. Provider business mailing address

410 SE 16TH CT APT 802
FORT LAUDERDALE FL
33316-2576
US

V. Phone/Fax

Practice location:
  • Phone: 856-889-5664
  • Fax:
Mailing address:
  • Phone: 856-889-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTIAN WILSON
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 856-889-5664