Bryan A Clark is a Surgical in Salt Lake City, Utah. Bryan A Clark practices all healthcare services and medical treatments related to Surgical. The NPI Number for Bryan A Clark is 1093777047. The last update date is 2016-04-22.
Bryan A Clark's current location address is Po Box 27128, Salt Lake City, Utah. You can contact this provider via phone number 8015717061. The mailing address for Bryan A Clark is Po Box 27128, Salt Lake City, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bryan A Clark |
|---|---|
| Address | Po Box 27128, Salt Lake City, Utah |
| Phone Number | 8015717061 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1093777047 |
|---|---|
| Provider Enumeration Date | 2006-04-05 |
| Last Updated Date | 2016-04-22 |
Provider Mailing Address Detail
| Address | Po Box 27128 |
|---|---|
| City | Salt Lake City |
| State | Utah (UT) |
| Post Code | 841270128 |
| Phone Number | 8015717061 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | 3231151206 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 107021850101 | UT | INTERMOUNTAIN HEALTH | |
| 999000116008 | UT | -- |
Post Comment/ Review Below
What is the Bryan A Clark's 1093777047?
The Bryan A Clark's NPI (National Provider Identifier) Number is 1093777047. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Bryan A Clark's facilities are situated?
The facilities of Bryan A Clark are physically located at the following address: Po Box 27128, Salt Lake City, UT, 841270128.
What is Bryan A Clark's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Bryan A Clark is Surgical, and the taxonomy code that categorizes this field of expertise is 363As0400X.
On what date did Bryan A Clark receive its 1093777047 assignment from the Centers for Medicare & Medicaid Services?
The Bryan A Clark was assigned its 1093777047 on 2006-04-05, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Bryan A Clark most recently updated or revised?
The information pertaining to Bryan A Clark, including its address, specialty, and other relevant details, was last updated or revised on 2016-04-22.