Gary W Clark Dpm A Professional Corp

LBN: Gary W. Clark Inc
Gary W Clark Dpm A Professional Corp is an health care organization with primary practice located at 166 W 1325 N Suite 300, Cedar City UT 84720-7792. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Customized Equipment. Podiatric Medicine & Surgery Service Providers / Podiatrist is the primary health care specialty. Gary W. Clark Inc can be contacted via phone (435) 867-8521, or through Clark, Gary W via phone (435) 867-8521.

Contact Information

Primary practice address
166 W 1325 N Suite 300 Cedar City UT 84720-7792
Phone: (435) 867-8521
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Gary W Doctor of Podiatric Medicine (DPM)
Phone: (435) 867-8521

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 320729-0501 Utah
Suppliers / Customized Equipment 332BC3200X 3207290501 Utah

Profile Details

NPI number 1629140173
LBN Legal business name Gary W. Clark Inc
DBA Doing business as Gary W Clark Dpm A Professional Corp
Authorized official Clark, Gary W Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2006
Last updated Feb 22nd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629140173 NPPES
Utah MEDICAID 529212733004

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