Individual
ROBERT BRENT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97 S. PROFESSIONAL WAY, PAYSON, UT 84651
(801) 465-4896
(801) 465-4107
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
165559-1205
UT
Other
Enumeration date
07/17/2006
Last updated
11/27/2023
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