Provider Demographics
NPI:1215021282
Name:VOIGT, CLAYTON G (CRNA)
Entity Type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:G
Last Name:VOIGT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2921
Mailing Address - Country:US
Mailing Address - Phone:703-295-9360
Mailing Address - Fax:703-766-9725
Practice Address - Street 1:500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-316-5703
Practice Address - Fax:540-316-5701
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024073155367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215021282Medicaid
VA139180OtherTRIGON
VA484645OtherNCPPO
VA430043384OtherRAILROAD MEDICARE
VA301217OtherAMERIGROUP
VADF9000OtherRAILROAD MEDICARE
VAK142-0002OtherCARE FIRST 2005
VA301217OtherAMERIGROUP
VA430043384OtherRAILROAD MEDICARE