Clark, Chad Jeremy

Clark, Chad Jeremy is an individual health care provider with primary practice located at 900 Round Valley Dr Suite 200, Park City UT 84060-7552. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Clark, Chad Jeremy can be contacted via phone (435) 658-7400.

Contact Information

Primary practice address
900 Round Valley Dr Suite 200 Park City UT 84060-7552
Phone: (435) 658-7400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 46699 Colorado
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X DOS994 Hawaii
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 8984876-1204 Utah

Profile Details

NPI number 1346339496
LBN Legal business name Clark, Chad Jeremy
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Apr 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346339496 NPPES
Colorado Other 46699 LICENSE

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