Provider Demographics
NPI:1235448192
Name:MICHAEL H CLAYTON, MD, PC
Entity Type:Organization
Organization Name:MICHAEL H CLAYTON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HENSLEY
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-296-5426
Mailing Address - Street 1:2509 VIRGINIA ST NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4694
Mailing Address - Country:US
Mailing Address - Phone:505-296-5426
Mailing Address - Fax:505-296-1248
Practice Address - Street 1:2509 VIRGINIA ST NE
Practice Address - Street 2:SUITE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4694
Practice Address - Country:US
Practice Address - Phone:505-296-5426
Practice Address - Fax:505-296-1248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM8919207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty