Michael Clark, OD

Optometrist · Brigham City, UT

Individual Active NPI

NPI number 1558858464

Practice location

990 Medical Dr Ste G3
Brigham City, UT 84302
Phone
(435) 374-2097

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NPI record

NPI
1558858464
Entity type
Individual (Type 1)
Enumeration date
April 16, 2018
Last updated
June 4, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X 10841920-9934 UT
Corneal and Contact Management Optometrist 152WC0802X 10841920-9934 UT

Mailing address

990 Medical Dr Ste G3
Brigham City, UT 84302-3077
Phone
(435) 374-2097

Other practice locations (1)

  • 2850 N 2000 W Ste 202, Farr West, UT 84404-9230 · (801) 731-6326

About Dr. Clark

Michael Clark, OD is a healthcare provider registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 990 Medical Dr Ste G3, Brigham City, UT 84302. The NPI number 1558858464 was assigned on April 16, 2018 and the record was last updated on June 4, 2018.

Dr. Clark lists 2 licenses in the registry: #10841920-9934 (UT) for Optometrist; #10841920-9934 (UT) for Corneal and Contact Management Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Clark, OD?

The NPI number is 1558858464.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (435) 374-2097.

Where is Dr. Clark located?

990 Medical Dr Ste G3, Brigham City, UT 84302.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 152W00000X – Optometrist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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