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:
Authorized official contact:
Name: Clark, Gary W Doctor of Podiatric Medicine (DPM)
Phone: (435) 867-8521
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629140173 | NPPES |
| Utah | MEDICAID | 529212733004 |
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