Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 9355821-1205 | UT |
Y | 111NI0900X | Internist | 9355821-1205 | UT |
N | 207RX0202X | Medical Oncology | 9355821-1205 | UT |
NPI | 1063787315 |
---|---|
Provider Name | Clarke Low |
First Address | Holladay, UT 84124-3532 |
Second Address | Murray, UT 84107-5704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 04/02/2021 |