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Organization
UTAH PODIATRY GROUP LLC
Active
Organization
UTAH PODIATRY GROUP LLC
Active
Parent organization
UTAH PODIATRY GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UTAH PODIATRY GROUP LLC
Authorized official
SCOTT A CLARK (DPM)
(801) 505-0821
Entity
Organization
Contact information
Practice address
520 MEDICAL DR STE 230, BOUNTIFUL, UT 84010-8932
(801) 292-5070
Mailing address
PO BOX 849795, LOS ANGELES, CA 90084-9795
(801) 451-6060
(801) 797-9154
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000063660
MEDICARE PIN
UT
01
—
6152070010
DME PTAN
UT
Enumeration date
02/27/2017
Last updated
10/27/2025
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