Provider Demographics
NPI:1740420835
Name:KERR, CLIFTON DUANE (MD)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:DUANE
Last Name:KERR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 WEST 1000 NORTH
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337
Mailing Address - Country:US
Mailing Address - Phone:435-257-5542
Mailing Address - Fax:
Practice Address - Street 1:725 WEST 1000 NORTH
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337
Practice Address - Country:US
Practice Address - Phone:435-257-5542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT146197-1205208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice