Provider Demographics
NPI:1518059294
Name:SIEGEL, CLAYTON DREW (BS DC)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:DREW
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:BS DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-8651
Mailing Address - Country:US
Mailing Address - Phone:828-681-5681
Mailing Address - Fax:828-687-7661
Practice Address - Street 1:2712 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8651
Practice Address - Country:US
Practice Address - Phone:828-681-5681
Practice Address - Fax:828-687-7661
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC2410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0821LOtherBCBS
NC890821LMedicaid
NC890821LMedicaid
2450948Medicare ID - Type Unspecified