Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | E6283 | TX |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 47915 | CO |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | E6283 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 47915 | CO |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | E6283 | TX |
NPI | 1235179300 |
---|---|
Provider Name | Thomas O. Clanton |
First Address | Vail, CO 81657-5242 |
Second Address | Vail, CO 81657-5242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 24/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133833701 | CSHCN (01) | |
133833706 | (05) | TX |
45851336 | (05) | CO |
81Z181 | BCBSTX (01) | TX |
B21877 | (02) | TX |