Healthcare Provider Details

I. General information

NPI: 1316421753
Provider Name (Legal Business Name): SCOTT ANDREW CLAWSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7321 BALMER ST BLDG 570
HILL AFB UT
84056-5012
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 801-777-4710
  • Fax:
Mailing address:
  • Phone: 210-292-7805
  • Fax: 210-292-7868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102209057
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: