Provider Demographics
NPI:1639232853
Name:CLAYTON, MARCUS K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:K
Last Name:CLAYTON
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 1:1226 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5736
Mailing Address - Country:US
Mailing Address - Phone:540-897-0003
Mailing Address - Fax:
Practice Address - Street 1:1226 4TH ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5736
Practice Address - Country:US
Practice Address - Phone:540-897-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL023049207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5H169Medicare ID - Type Unspecified
LAH12295Medicare UPIN