Individual
DERREL W CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 N 500 E, LOGAN, UT 84341-2400
(435) 792-1940
(435) 792-1692
Mailing address
1350 N 500 E, LOGAN, UT 84341-2400
(435) 792-1940
(435) 792-1692
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1863221205
UT
Other
Enumeration date
07/31/2006
Last updated
10/14/2008
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