Provider Demographics
NPI:1619960549
Name:CLAY, RICHARD LLOYD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LLOYD
Last Name:CLAY
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 1:201 SIVLEY RD SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5134
Mailing Address - Country:US
Mailing Address - Phone:256-533-1077
Mailing Address - Fax:256-533-3379
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-533-1077
Practice Address - Fax:256-533-3379
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01092607A208G00000X
AL15210208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300086605Medicaid
AL000027957Medicaid
AL000027957Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ALE68291Medicare UPIN