Clardy, Stacey
Clardy, Stacey is an individual health care provider with primary practice located at 50 N Medical Dr , Salt Lake City UT 84132-0100. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Clardy, Stacey can be contacted via phone (801) 585-6387.Contact Information
Primary practice address
50 N Medical Dr
Salt Lake City UT 84132-0100
Phone: (801) 585-6387
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 8615909-1205 | Utah |
Profile Details
| NPI number | 1073735015 |
|---|---|
| LBN Legal business name | Clardy, Stacey |
| Credentials | M.D. PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2007 |
| Last updated | Nov 12th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073735015 | NPPES |
| Minnesota | MEDICAID | ENROLLED |
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