Gary W. Clark a Professional Corporation

Organization Active NPI Customized Equipment (DME) · Milford, UT

NPI 1699847780 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1699847780
Entity type
Organization (NPI type 2)
Primary specialty
Customized Equipment (DME) 332BC3200X
License
3207290501 (UT)
Legal business name
GARY W. CLARK A PROFESSIONAL CORPORATION
Practice address
444 S. Main
Milford, UT 84751
Phone
(888) 437-3668
NPI assigned
Nov 14, 2006
Organization subpart
No

Authorized official

Name
Dr. Gary W. Clark, DPM NPI 1609861152
Title
Owner
Phone
(888) 437-3668

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Gary W Clark DPM a Professional Corporation (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 3207290501 UT Yes

Addresses

Primary practice location

444 S. Main
Milford, UT 84751

Mailing address

166 W 1325 N Ste 300
Cedar City, UT 84720-7854
Phone (435) 867-8521

Other providers in Milford, UT

All providers in Milford, UT · Customized Equipment (DME) in Utah

Sources for this page

Verify at the official NPI Registry.