Individual
DR. CLAYTON A BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5475 S 500 E, OGDEN, UT 84405-6905
(801) 463-7415
(801) 463-7341
Mailing address
370 E SOUTH TEMPLE STE 260, SALT LAKE CITY, UT 84111-1290
(801) 463-7415
(801) 463-7341
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
045167
GA
207P00000X
Emergency Medicine Physician
13154
MS
207P00000X
Emergency Medicine Physician
Primary
6068769-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000784924D
—
GA
05
—
06559318
—
MS
05
—
1490261
—
LA
01
—
52755548-002
BCBS
GA
Enumeration date
09/20/2005
Last updated
07/09/2009
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