Individual
KYLE DAVID CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3337
(801) 357-7850
Mailing address
1034 N 500 W, PROVO, UT 84604-3337
(801) 357-7850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8841564-1205
UT
208M00000X
Hospitalist Physician
Primary
8841564-1205
UT
Other
Enumeration date
04/23/2012
Last updated
04/09/2024
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