Provider Demographics
NPI:1578544094
Name:HUNTLEY, ARTHUR CLAYTON (MD)
Entity Type:Individual
Prefix:PROF
First Name:ARTHUR
Middle Name:CLAYTON
Last Name:HUNTLEY
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 1:4860 Y ST
Mailing Address - Street 2:DEPARTMENT OF DERMATOLOGY SUITE 3400
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-6795
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:DEPARTMENT OF DERMATOLOGY SUITE 3400
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6795
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24292207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A242920Medicaid
CAA23897Medicare UPIN