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Individual

DR. CLARK JOHN STAHELI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8555 NORTH HIGHWAY 18, DAMMERON VALLEY, UT 84783
(435) 574-2546
(435) 574-2619
Mailing address
8555 NORTH HIGHWAY 18, DAMMERON VALLEY, UT 84783
(801) 429-8000
(801) 429-8150

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
148105-1205
UT
207Q00000X
Family Medicine Physician
1481051205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03698
UT
Enumeration date
02/15/2007
Last updated
03/22/2011
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