Dr Brian Robert Clark, DDS is a medicare enrolled "Dentist - General Practice" provider in Kamas, Utah. His current practice location is
228 W 200 S Ste 1a, Kamas, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 783-2273.
Dr Brian Robert Clark is licensed to practice in Utah (license number 10974038) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689730533.
Healthcare Provider's Profile
Full Name | Dr Brian Robert Clark |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 228 W 200 S Ste 1a, Kamas, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1689730533
- Provider Enumeration Date: 12/28/2006
- Last Update Date: 03/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 3870886872
- Enrollment ID: I20160728001582
Medical Identifiers
Medical identifiers for Dr Brian Robert Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689730533 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 10974038 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brian Robert Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Brian Robert Clark, DDS 228 W 200 S Ste 1a, Kamas, UT 84036-9010 Ph: (435) 783-2273 | Dr Brian Robert Clark, DDS 228 W 200 S Ste 1a, Kamas, UT 84036-9010 Ph: (435) 783-2273 |
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