Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Chad Jeremy Clark, DO

Individual provider Family Medicine Physician · NPI 1346339496

Chad Jeremy Clark, DO is an Obstetrics/Gynecology in Park City, Utah. Qualified in 2001, 25 years ago. Practices with Kauai Medical Clinic, a 150-clinician group and accepts Medicare assignment. Licensed in Colorado, Hawaii and Utah.

Years since qualifying
25
Licensed in
CO, HI, UT
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

900 Round Valley Dr Ste 200
Park City, UT 84060-7552
Phone: (435) 658-7400
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 8984876-1204 (UT)
Family Medicine Physician Taxonomy 207Q00000X · Licence 46699 (CO)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence DOS994 (HI)

Record details

NPI number1346339496
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedOctober 12, 2006
Last updated in NPPESApril 20, 2023
Certification dateApril 20, 2023
Mailing addressPo Box 30180, Salt Lake City, UT 84130-0180

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Kauai Medical Clinic — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Park City