Healthcare Provider Details

I. General information

NPI: 1740420835
Provider Name (Legal Business Name): CLIFTON DUANE KERR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WEST 1000 NORTH
TREMONTON UT
84337
US

IV. Provider business mailing address

725 WEST 1000 NORTH
TREMONTON UT
84337
US

V. Phone/Fax

Practice location:
  • Phone: 435-257-5542
  • Fax:
Mailing address:
  • Phone: 435-257-5542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number146197-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: