Provider Demographics
NPI:1376627166
Name:WILLIAMS, CLAYTON P (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:P
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:327 DAHLONEGA STREET
Mailing Address - Street 2:BUILDING 1200
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:770-887-2303
Mailing Address - Fax:678-807-7840
Practice Address - Street 1:327 DAHLONEGA STREET
Practice Address - Street 2:BUILDING 1200
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:770-887-2303
Practice Address - Fax:678-807-7840
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDCFMedicare ID - Type Unspecified
U57855Medicare UPIN