Individual
DR. KEVIN N CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 MEDICAL DR, STE 101, BOUNTIFUL, UT 84010-4945
(801) 298-9409
(801) 292-1271
Mailing address
425 MEDICAL DR, STE 101, BOUNTIFUL, UT 84010-4945
(801) 298-9409
(801) 292-1271
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
901831861205
UT
Other
Enumeration date
10/12/2005
Last updated
10/19/2011
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