Provider Demographics
NPI:1295860112
Name:CLAXTON, DONALD ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALEXANDER
Last Name:CLAXTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 MERRICK RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3338
Mailing Address - Country:US
Mailing Address - Phone:516-442-4728
Mailing Address - Fax:
Practice Address - Street 1:155 MASON ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-6621
Practice Address - Country:US
Practice Address - Phone:410-262-4925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159980208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70767Medicare UPIN