NPI 1700865748 · live from the CMS NPI Registry
Scott A Clark, DPM
Podiatrist, Foot & Ankle Surgery in Salt Lake City, UT. National Provider Identifier 1700865748, active.
NPI record
| NPI | 1700865748 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 24 S 1100 E Ste 210, Salt Lake City, UT 84102 |
| Practice phone | 801-505-5277 |
| Mailing address | Po Box 540610, N Salt Lake, UT 84054 |
| Enumerated | January 10, 2006 |
| Last updated | February 19, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 106339-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.