NPI 1609861152 · live from the CMS NPI Registry
Gary W Clark, DPM
Podiatrist in Cedar City, UT. National Provider Identifier 1609861152, active.
NPI record
| NPI | 1609861152 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 166 W 1325 N, Suite 300, Cedar City, UT 84721 |
| Practice phone | 435-867-8521 |
| Mailing address | Po Box 1986, Cedar City, UT 84721 |
| Enumerated | September 12, 2005 |
| Last updated | March 27, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 320729-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.