Sudabeh Clark in Cottonwood Heights - Physician Assistant
Sudabeh Clark - NPI 1871790725
Sudabeh Clark is a Physician Assistant in Cottonwood Heights, Utah. Sudabeh Clark practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Sudabeh Clark is 1871790725. The last update date is 2022-12-28.
Sudabeh Clark's current location address is 8275 S Supernal Way, Cottonwood Heights, Utah. You can contact this provider via phone number 3109639404. The mailing address for Sudabeh Clark is 8275 S Supernal Way, Cottonwood Heights, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sudabeh Clark |
|---|---|
| Address | 8275 S Supernal Way, Cottonwood Heights, Utah |
| Phone Number | 3109639404 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1871790725 |
|---|---|
| Provider Enumeration Date | 2007-07-02 |
| Last Updated Date | 2022-12-28 |
Provider Mailing Address Detail
| Address | 8275 S Supernal Way |
|---|---|
| City | Cottonwood Heights |
| State | Utah (UT) |
| Post Code | 841216023 |
| Phone Number | 3109639404 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 11172710-120 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
What is the Sudabeh Clark's unique identification number?
The Sudabeh Clark has been assigned the NPI (National Provider Identifier) Number 1871790725 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Sudabeh Clark's physical address?
The Sudabeh Clark is physically located at 8275 S Supernal Way, in the city of Cottonwood Heights, UT, with the postal code 841216023.
What is Sudabeh Clark's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Sudabeh Clark's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
When did Sudabeh Clark receive its 1871790725 assignment?
The Sudabeh Clark was assigned its 1871790725 on 2007-07-02, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Sudabeh Clark, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Sudabeh Clark, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-12-28.