Provider Demographics
NPI:1114979184
Name:CLAYTON, CHERYL BUTTRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:BUTTRAM
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:854 W JAMES CAMPBELL BLVD
Mailing Address - Street 2:STE. 101A
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4659
Mailing Address - Country:US
Mailing Address - Phone:931-388-3209
Mailing Address - Fax:931-388-0105
Practice Address - Street 1:854 W JAMES CAMPBELL BLVD
Practice Address - Street 2:STE. 101A
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4659
Practice Address - Country:US
Practice Address - Phone:931-388-3209
Practice Address - Fax:931-388-0105
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43550207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507439Medicaid
I30873Medicare UPIN
TN3001769Medicare PIN