Robert Brent Clark MD

NPI 1689692071 - Family Medicine - 207Q00000X

NPI Details
NPI 1689692071
Gender Male
Enumeration Date 07/17/2006
Last Updated 11/20/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
97 S. PROFESSIONAL WAY
PAYSON UT, 84651, US
Phone (801) 465-4896
Fax (801) 465-3267
Business Location
1055 N 500 W
PROVO UT, 84604-3305, US
Phone (801) 465-4896
Fax (801) 465-3267
Toxanomy
Taxonomy Code 207Q00000X
License State Utah
License Number 165559-1205
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According to our database, Robert Brent Clark MD NPI is 1689692071, taxonomy code is 207Q00000X and license number is 165559-1205, license state is located at Utah. Robert Brent Clark MD physically located at 97 S. Professional Way, Payson UT, 84651. NPI Number Robert Brent Clark MD has the Individual type.

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1689692071 NPI number is provided on an as is basis without warranty of any kind. 1689692071 is maintained by the National Plan & Provider Enumeration System. The contents of Robert Brent Clark MD are for informational purposes only.