Organization
UTAH PODIATRY GROUP PC
Active
Other names
Advanced Foot And Ankle Center
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A CLARK (DPM)
(801) 505-5277
Entity
Organization
Contact information
Practice address
6321 S REDWOOD RD STE 102, TAYLORSVILLE, UT 84123-6799
(801) 505-5277
(801) 505-5280
Mailing address
24 S 1100 E STE 210, SALT LAKE CITY, UT 84102-1580
(801) 505-5277
(801) 505-5280
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106339-0501
LICENSE
UT
Enumeration date
09/12/2018
Last updated
04/21/2020
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