Provider Demographics
NPI:1083657407
Name:SEIPLE, CLAYTON W (DO)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:W
Last Name:SEIPLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44222-0640
Mailing Address - Country:US
Mailing Address - Phone:330-655-3820
Mailing Address - Fax:330-655-3825
Practice Address - Street 1:5655 HUDSON DR STE 130
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4454
Practice Address - Country:US
Practice Address - Phone:330-655-3820
Practice Address - Fax:330-655-3825
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34006948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2316167Medicaid
4047973Medicare PIN
P00276658Medicare PIN
H16162Medicare UPIN