| Douglas R Clawson | |
|
298 24th St Ste 204 Ogden UT 84401-1870 | |
| (801) 317-3809 | |
| Not Available |
| Full Name | Douglas R Clawson |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 298 24th St Ste 204, Ogden, Utah |
| Authorized Official Name and Position | Douglas Rockwell Clawson (SOLE PROPRIETOR) |
| Authorized Official Contact | 8013173809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas R Clawson 481 E 1950 N North Ogden UT 84414-3015 Ph: (801) 317-3809 | Douglas R Clawson 298 24th St Ste 204 Ogden UT 84401-1870 Ph: (801) 317-3809 |
| NPI Number | 1205314747 |
|---|---|
| Provider Enumeration Date | 08/06/2018 |
| Last Update Date | 03/14/2022 |
| Certification Date | 03/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205314747 | NPI | - | NPPES |
| 18173560 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 6720347-3501 (Utah) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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