NPI 1073735015 · live from the CMS NPI Registry
Stacey Clardy, M.D. Ph.D.
Psychiatry & Neurology, Neurology in Salt Lake City, UT. National Provider Identifier 1073735015, active.
NPI record
| NPI | 1073735015 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 50 N Medical Dr, Salt Lake City, UT 84132 |
| Practice phone | 801-585-6387 |
| Mailing address | Po Box 413027, Salt Lake City, UT 84141 |
| Enumerated | May 2, 2007 |
| Last updated | November 12, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 8615909-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.