Provider Demographics
NPI:1134467996
Name:PITTS, CLAYTON LOWERY (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:LOWERY
Last Name:PITTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LAKELAND SQUARE EXT 400
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:601-383-6468
Mailing Address - Fax:601-932-6557
Practice Address - Street 1:1000 LAKELAND SQUARE EXT STE 400
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7621
Practice Address - Country:US
Practice Address - Phone:601-932-3855
Practice Address - Fax:601-956-8865
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01950356Medicaid