Individual provider · NPI-1

Scott A Clark, DPM

Podiatrist, Foot & Ankle Surgery · Salt Lake City, UT

NPI number1700865748
StatusActive
Last updated in NPPESFeb 19, 2020

Details

NPI
1700865748
Entity type
Individual (NPI-1)
Name
Scott A Clark
Credential
DPM
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 10, 2006
Certification date
Feb 19, 2020
Last updated
Feb 19, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0103X Podiatrist, Foot & Ankle Surgery106339-0501UTYes

Practice location

24 S 1100 E Ste 210
Salt Lake City, UT 84102

Phone 801-505-5277 · Fax 801-505-5280

Mailing address

Po Box 540610
N Salt Lake, UT 84054-0610

Phone 801-451-6060 · Fax 801-296-0218

Other practice locations

2159 S 700 E Ste 150
Salt Lake City, UT 84106-2279

Phone 801-466-1333 · Fax 801-466-6601

8822 S Redwood Rd Ste E121
West Jordan, UT 84088-5763

Phone 801-285-7060 · Fax 801-285-7061

3435 E Pony Express Pkwy Ste 140
Eagle Mountain, UT 84005-5548

Phone 801-692-3868 · Fax 801-789-2406

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