MICHAEL CLARK (NPI# 1558858464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558858464 |
| Entity Type | Individual |
| Full Name | MICHAEL CLARK |
| Credential | OD |
| Practice Address |
990 Medical Dr Ste G3 Brigham City UT 84302 |
| Mailing Address |
990 Medical Dr Ste G3 Brigham City UT 84302-3077 |
| Practice Telephone | 4353742097 |
| Mailing Telephone | 4353742097 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 10841920-9934 | UT | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
10841920-9934 | UT | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2850 N 2000 W Ste 202, Farr West, UT 844049230 | 8017316326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| 1457663023 | Michael Ahart Clark | Massage Therapist | 2010 Mount Zion Rd, C, Morrow, GA 30260-3314 | 2010-07-11 |
| Street Address |
990 MEDICAL DR STE G3 |
| City | BRIGHAM CITY |
| State | UT |
| Zip Code | 84302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945531 | Brandon Lee Allen | Counselor | 971 South 800 West, #104, Brigham City, UT 84302 | 2019-01-03 |
| 1104307495 | Tiffany Burnhope | Social Worker | 663 Parker Lane, Brigham City, UT 84302 | 2018-08-24 |
| 1497273130 | Emily Marler | Counselor | 862 South Main Suite 4, Brigham City, UT 84302 | 2017-09-01 |
| 1003268731 | Tyler Beckstrand | Social Worker | 125 N Main Street, Brigham City, UT 84302 | 2016-07-06 |
| 1780030155 | Angela Stott | Case Manager/Care Coordinator | 160 E 800 S Apt. B216, Brigham City, UT 84302 | 2016-05-04 |
| 1699156802 | Christopher Jacobson | Family Medicine | 1050 Medical Dr, Brigham City, UT 84302 | 2015-06-12 |
| 1811377765 | Courtney Allred | Counselor | 863 S Main Street Suite 2, Brigham, UT 84302 | 2015-06-05 |
| 1235529579 | Belinda Castro | Counselor | 862 S Main Street Suite 2, Brigham City, UT 84302 | 2015-01-26 |
| 1760871818 | Ambryn Mccallson | Counselor | 862 S. Main, 4, Brigham City, UT 84302 | 2015-01-13 |
| 1609273309 | A Home Health Care | Home Health | 9 W Forest St. Suite 208, Brigham City, UT 84302 | 2014-11-24 |
| Find all providers in zip 84302 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497015382 | Eye & Vision Care, LLC | Optometrist | 547 S Main St, Brigham City, UT 84302-3244 | 2012-05-24 |
| 1386694677 | Scott Roberts Haderlie | Optometrist | 747 S Main St, Brigham City, UT 84302-3359 | 2006-05-10 |
| 1487653218 | David P. Lewis | Optometrist | 990 South Medical Dr, Suite G3, Brigham City, UT 84302-3077 | 2005-07-14 |
| 1235138066 | Richard J. Bigler | Optometrist | 990 South Medical Drive, Suite Gl3, Brigham City, UT 84302 | 2005-07-14 |
| 1033471339 | Joseph C. Olson | Optometrist | 547 S Main St, Brigham City, UT 84302-3244 | 2012-06-12 |
| 1427115831 | David P. Lewis Md PC | Optometrist | 990 Medical Dr, Brigham City, UT 84302-4713 | 2007-01-03 |
| 1124068788 | William L Harrison | Optometrist | 111 E Forest St, Suite E, Brigham City, UT 84302-2127 | 2006-06-08 |
| 1700839545 | Shopko Stores Operating Co. LLC | Optometrist | 747 S Main St, Brigham City, UT 84302-3359 | 2006-05-19 |
| 1437137379 | Larry D Terry | Optometrist | 34 S Main St, Brigham City, UT 84302-2527 | 2005-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351383 | National Vision Inc | Optometrist | 3857 West Campus View Drive, Suite 110, West Jordan, UT 84084 | 2020-09-16 |
| 1104443159 | National Vision Inc | Optometrist | 1917 W 1800 N Ste D1, Clinton, UT 84015-8558 | 2020-06-25 |
| 1295350247 | Victoria Nielsen | Optometrist | 4934 S Plymouth View Dr, Taylorsville, UT 84123-4204 | 2020-06-15 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1013532894 | Meagan Miles | Optometrist | 1752 W 400 N Apt B, Salt Lake City, UT 84116-3546 | 2020-06-08 |
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1225651011 | Bethany Ruth Gillett | Optometrist | 3029 S Colt Plaza Dr Ste 1, West Valley City, UT 84128-4015 | 2020-05-27 |
| 1881217446 | Collin Robert Gray | Optometrist | 75 W State St, Lehi, UT 84043-1546 | 2020-05-18 |
| 1841820792 | Clifford Parker | Optometrist | 4283 Harrison Blvd, Ogden, UT 84403-3101 | 2020-01-20 |
| 1598303075 | Choice Eye Center, LLC | Optometrist | 12272 S 800 E Ste 100a, Draper, UT 84020-9776 | 2019-12-16 |
| Find all providers with the same taxonomy | ||||
| City | BRIGHAM CITY |
| Zip Code | 84302 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.