Individual
JAY AUSTIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
170 N 1100 E, AMERICAN FORK, UT 84003-2096
(801) 357-2480
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-2480
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4939552-1205
UT
Other
Enumeration date
07/17/2006
Last updated
09/08/2021
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