Dr Stanley Corbin Clark, MD | |
9690 S 1300 E, 100, Sandy, UT 84094-3721 | |
(801) 571-5121 | |
(801) 572-5358 |
Full Name | Dr Stanley Corbin Clark |
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Gender | Male |
Speciality | Urology |
Location | 9690 S 1300 E, Sandy, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770591620 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 172492-1205 (Utah) | Primary |
Entity Name | Providence Health & Services Washington |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174744304 PECOS PAC ID: 6709782600 Enrollment ID: O20031211000028 |
Entity Name | Providence Health & Services Washington |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619176997 PECOS PAC ID: 7719873496 Enrollment ID: O20040227000744 |
Mailing Address | Practice Location Address |
---|---|
Dr Stanley Corbin Clark, MD 9690 S 1300 E, 100, Sandy, UT 84094-3721 Ph: (801) 571-5121 | Dr Stanley Corbin Clark, MD 9690 S 1300 E, 100, Sandy, UT 84094-3721 Ph: (801) 571-5121 |
Dr. Elisabeth A Ferlic, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 9720 S 1300 E, Suite E230, Sandy, UT 84094 Phone: 801-501-2950 Fax: 801-501-2951 | |
Dr. Richard Francis Labasky, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 9600 S 1300 E, #303, Sandy, UT 84094 Phone: 801-501-5300 Fax: 801-501-5350 | |
Dr. Jay B Page, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 9600 S 1300 E Ste 240, Sandy, UT 84094 Phone: 801-993-1800 |