Jayne Elizabeth Clark, M.D.

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Holladay, UT

NPI 1295735728 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1295735728
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
165700-1205 (UT)
Practice address
2180 E 4500 S
Suite #185
Holladay, UT 84117-4434
Phone
(801) 272-6972
Fax
(801) 272-6953
NPI assigned
Jul 27, 2005
Sex
Female
Sole proprietor
No

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 Medicine

State licenses

LicenseStateTypeSpecialty
165700-1205UTMDPhysical Medicine & Rehabilitation Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 165700-1205 UT Yes

Addresses

Primary practice location

2180 E 4500 S
Suite #185
Holladay, UT 84117-4434

Mailing address

2180 E 4500 S
Suite #185
Holladay, UT 84117-4434
Phone (801) 272-6972

Other providers in Holladay, UT

All providers in Holladay, UT · Physical Medicine & Rehabilitation Physician in Utah

Sources for this page

Verify at the official NPI Registry.