Provider Demographics
NPI:1952580326
Name:DOCTOR KARA, P.C.
Entity Type:Organization
Organization Name:DOCTOR KARA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND SOLE SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:ELAYNE
Authorized Official - Last Name:DIERSING CLAPP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NP-C
Authorized Official - Phone:801-495-9303
Mailing Address - Street 1:880 E 9400 S STE 116
Mailing Address - Street 2:SOUTHWOOD MEDICAL PAVILION
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4100
Mailing Address - Country:US
Mailing Address - Phone:801-495-9303
Mailing Address - Fax:801-495-9670
Practice Address - Street 1:880 E 9400 S STE 116
Practice Address - Street 2:SOUTHWOOD MEDICAL PAVILION
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4100
Practice Address - Country:US
Practice Address - Phone:801-495-9303
Practice Address - Fax:801-495-9670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTOR KARA, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49308814405261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care