Individual
DR. MATTHEW ALEXANDER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UTE MOUNTAIN UTE HEALTH CENTER, COMPLEX B RUSTLING WILLOW STREET, TOWAOC, CO 81334-0049
(970) 565-4441
Mailing address
PO BOX 49, TOWAOC, CO 81334-0049
(970) 565-4441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39323
CO
208000000X
Pediatrics Physician
39323
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24857751
—
CO
Enumeration date
04/26/2006
Last updated
10/05/2009
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