Provider Demographics
NPI:1497704175
Name:MAYNOR, ROBERT CLAYTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLAYTON
Last Name:MAYNOR
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3501 MEMORIAL PKWY SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5319
Mailing Address - Country:US
Mailing Address - Phone:256-533-0315
Mailing Address - Fax:256-533-0422
Practice Address - Street 1:3501 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5319
Practice Address - Country:US
Practice Address - Phone:256-533-0315
Practice Address - Fax:256-533-0422
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-09-13
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00005458207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529904260-8936Medicaid
AL529904260-8936Medicaid
ALC75213Medicare UPIN