Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 163081-1205 | UT |
N | 208600000X | Surgeon | 163081-1205 | UT |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 163081-1205 | UT |
NPI | 1265434823 |
---|---|
Provider Name | Dr. James M Clayton JR. |
First Address | Provo, UT 84604-5764 |
Second Address | Provo, UT 84604-5764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 17/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D20161 | (02) |