SCOTT A CLARK (NPI# 1700865748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700865748 |
| Entity Type | Individual |
| Full Name | SCOTT A CLARK |
| Credential | DPM |
| Practice Address |
24 S 1100 E Ste 210 Salt Lake City UT 84102 |
| Mailing Address |
Po Box 540610 N Salt Lake UT 84054-0610 |
| Practice Telephone | 8015055277 |
| Practice Fax Number | 8015055280 |
| Mailing Telephone | 8014516060 |
| Mailing Fax Number | 8012960218 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
106339-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2159 S 700 E Ste 150, Salt Lake City, UT 841062279 | 8014661333 | 8014666601 |
| 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT 840055548 | 8016923868 | 8017892406 |
| 8822 S Redwood Rd Ste E121, West Jordan, UT 840885763 | 8012857060 | 8012857061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275650657 | Scott C Clark | Chiropractor | 1540 N Arlington Heights Rd, Arlington Heights, IL 60004-3906 | 2007-03-23 |
| 1205903754 | Scott Clark | Optometrist | 491 Rantoul St, Beverly, MA 01915-3231 | 2006-11-29 |
| 1225119191 | Scott Earl Clark | Physician Assistant | 6 Fountain Plaza, Buffalo, NY 14202 | 2006-10-18 |
| 1255440475 | Scott Clark | Physician Assistant | 1503 Buenos Aires Blvd Ste 100, The Villages, FL 32159-6825 | 2006-08-30 |
| 1265490734 | Scott Matthew Clark | Chiropractor | 8000 Dallas St, Fort Smith, AR 72903-4277 | 2006-05-03 |
| 1336752286 | Scott Clark | Behavior Technician | 5457 Sw Canyon Ct, Portland, OR 97221-2401 | 2020-08-28 |
| 1518528868 | Scott Randall Clark | Nurse Practitioner | 809 W Randol Mill Rd, Arlington, TX 76012-2507 | 2019-06-27 |
| 1487163002 | Scott Thomas Clark | Counselor | 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2017-09-26 |
| 1710432984 | Scott Clark | Pharmacist | 100 W Riverside Dr, Parker, AZ 85344-5205 | 2016-08-17 |
| 1316331994 | Scott Clark Jr. | Registered Nurse | 2250 Wehrle Dr, Suite 1, Williamsville, NY 14221-7034 | 2015-03-23 |
| Street Address |
24 S 1100 E STE 210 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1972875524 | Utah Podiatry Group PC | Podiatrist | 2159 S 700 E Ste 150, Salt Lake City, UT 84106 | 2012-01-29 |
| 1891082830 | Selina Sekulic | Podiatrist | 348 E 4500 S Ste 370, Salt Lake City, UT 84107-3906 | 2011-06-28 |
| 1841586096 | Brian B Liljenquist | Podiatrist | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124 | 2011-06-27 |
| 1659683381 | Christiaan Horst Goebel | Podiatrist | 4578 S Highland Dr, Suite 380, Salt Lake City, UT 84117-4243 | 2010-07-10 |
| 1639306889 | Daniel L Preece | Podiatrist | 430 N 400 W, Salt Lake City, UT 84103-1229 | 2009-06-15 |
| 1962513820 | Jason Ross Bowen | Podiatrist | 3710 Twinbrook St, Salt Lake City, UT 84109-3714 | 2006-08-31 |
| 1760499180 | Paul Norman Daniels | Podiatrist | 1449 E 3300 S, Salt Lake City, UT 84106-3308 | 2006-08-01 |
| 1710955745 | Flegal Foot & Ankle Clinic, LLC | Podiatrist | 740 E 3900 S, Suite 108, Salt Lake City, UT 84107-2525 | 2006-03-08 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
Please comment or provide details below to improve the information on SCOTT A CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.