Individual
THOMAS H CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
595 W 465 N, PROVIDENCE, UT 84332
(385) 238-3900
(385) 238-3901
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
(801) 475-3489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6049303-1205
UT
Other
Enumeration date
07/31/2006
Last updated
02/05/2024
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