Provider Demographics
NPI:1437724838
Name:GRIFFITH, CLAYTON RAY
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:RAY
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S ADA ST
Mailing Address - Street 2:
Mailing Address - City:COALGATE
Mailing Address - State:OK
Mailing Address - Zip Code:74538-3826
Mailing Address - Country:US
Mailing Address - Phone:580-258-8373
Mailing Address - Fax:
Practice Address - Street 1:605 S ADA ST
Practice Address - Street 2:
Practice Address - City:COALGATE
Practice Address - State:OK
Practice Address - Zip Code:74538-3826
Practice Address - Country:US
Practice Address - Phone:580-258-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator