Provider Demographics
NPI:1205371762
Name:WCJ MEDICAL PLLC
Entity Type:Organization
Organization Name:WCJ MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:F
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-269-3095
Mailing Address - Street 1:PO BOX 681884
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1884
Mailing Address - Country:US
Mailing Address - Phone:615-396-5003
Mailing Address - Fax:615-396-5283
Practice Address - Street 1:1840 MEDICAL CENTER PKWY
Practice Address - Street 2:STE. 404
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3199
Practice Address - Country:US
Practice Address - Phone:615-396-5003
Practice Address - Fax:615-396-5283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43469207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty