Organization
UTAH PODIATRY GROUP LLC
Active
Parent organization
UTAH PODIATRY GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UTAH PODIATRY GROUP LLC
Authorized official
SCOTT A CLARK (DPM)
(801) 505-0821
Entity
Organization
Contact information
Practice address
520 MEDICAL DR STE 230, BOUNTIFUL, UT 84010-8932
(801) 292-5070
Mailing address
PO BOX 849795, LOS ANGELES, CA 90084-9795
(801) 451-6060
(801) 797-9154
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000063660
MEDICARE PIN
UT
01
—
6152070010
DME PTAN
UT
Enumeration date
02/27/2017
Last updated
10/27/2025
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