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Individual

CLAYTON DENNING KILLPACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9660 S 1300 E, SANDY, UT 84094-3762
(801) 993-9582
(801) 733-5618
Mailing address
2975 EXECUTIVE PKWY, 200, LEHI, UT 84043-9642
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
115334
MT
207L00000X
Anesthesiology Physician
Primary
4979083-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100503296
NV
01
107027653101
IHC
UT
05
119676600
WY
01
1502954
UMWA
UT
01
2090168
UNITED HEALTHCARE
UT
01
49790831200001
BCBS
UT
01
77516
PEHP
UT
05
806874300
ID
01
826031
HEALTHY U
UT
01
850808
DESERET MUTUAL
UT
05
859647
AZ
01
870545614KIL
EDUCATORS MUTUAL
UT
01
QM0000075886
ALTIUS
UT
01
TPRA09320
MOLINA
UT
Enumeration date
09/01/2006
Last updated
09/08/2022
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