Clark, Holly

Clark, Holly is an individual health care provider with primary practice located at 1250 E 3900 S Suite 360, Salt Lake City UT 84124-1348. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Clark, Holly can be contacted via phone (801) 263-3041.

Contact Information

Primary practice address
1250 E 3900 S Suite 360 Salt Lake City UT 84124-1348
Phone: (801) 263-3041
Fax: (801) 263-8485
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 4977163 Utah

Profile Details

NPI number 1376639047
LBN Legal business name Clark, Holly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jun 9th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376639047 NPPES
Utah Other 49771631200001 BLUE CROSS BLUE SHIELD
Utah Other 49771631200001 BLUE CROSS BLUE SHIELD
Utah Other 49771631200001 BLUE CROSS BLUE SHIELD
Utah Other 78498 BLUE CROSS BLUE SHIELD
Utah Other QM0000217387 BLUE CROSS BLUE SHIELD

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