Provider Demographics
NPI:1558335281
Name:CLAYTOR, JAMES EMERY (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EMERY
Last Name:CLAYTOR
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 1:125 ALPINE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223
Mailing Address - Country:US
Mailing Address - Phone:803-779-3548
Mailing Address - Fax:803-779-7055
Practice Address - Street 1:125 ALPINE CIRCLE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223
Practice Address - Country:US
Practice Address - Phone:803-779-3548
Practice Address - Fax:803-779-7055
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC0172682084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC400186Medicaid
582296052001OtherBCBS PALMETTO HEALTH
SC400186Medicaid