Individual
JEFFREY G. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 587-3543
Mailing address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 587-3543
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10564219-1205
UT
Other
Enumeration date
04/20/2015
Last updated
08/28/2022
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