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Individual

CLARK K. LOFTUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
620 MEDICAL DR, #100, BOUNTIFUL, UT 84010-5084
(801) 295-2888
(801) 295-0311
Mailing address
620 MEDICAL DR, #100, BOUNTIFUL, UT 84010-5084
(801) 295-2888
(801) 295-0311

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
248724-1205
UT
208000000X
Pediatrics Physician
40502
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15287220
CO
Enumeration date
11/28/2005
Last updated
07/26/2013
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