Jeffrey Clark, PHARMD
Individual provider Active NPI Pharmacist · Springville, UT
NPI 1023665288 · NPPES record last updated Aug 22, 2019
Key facts
- NPI
- 1023665288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5910037 (UT)
- Practice address
- 1117 W 400 S
Springville, UT 84663-3061 - Phone
- (385) 685-7005
- NPI assigned
- Aug 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5910037 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiths Food & Drug Centers Inc | Past |
Accepting new patients | |
| Smith'S Food & Drug Centers Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5910037 | UT | Yes |
Addresses
Primary practice location
1117 W 400 S
Springville, UT 84663-3061
Mailing address
446 Spanish Fields Dr
Spanish Fork, UT 84660-4519
Phone (801) 471-9312
Other providers in Springville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.