Organization
UNIVERSITY OF UTAH ADULT SERVICES
Active
Parent organization
UNIVERSITY OF UTAH ADULT SERVICES
Other names
Dermatology
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Authorized official
EDWARD J CLARK MD (DEPARTMENT CHAIR)
(801) 587-6336
Entity
Organization
Contact information
Practice address
165 N. UNIVERSITY AVE. FARMINGTON, FARMINGTON, UT 84025
(801) 213-3200
Mailing address
PO BOX 841450, LOS ANGELES, CA 90084-1450
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/12/2016
Last updated
05/19/2020
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