Provider Demographics
NPI:1710205265
Name:ELSWICK, CLAY MADISON (MD)
Entity Type:Individual
Prefix:
First Name:CLAY
Middle Name:MADISON
Last Name:ELSWICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:515 W MAYFIELD RD STE 407
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2085
Mailing Address - Country:US
Mailing Address - Phone:682-219-0357
Mailing Address - Fax:817-419-2943
Practice Address - Street 1:515 W MAYFIELD RD STE 407
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2085
Practice Address - Country:US
Practice Address - Phone:682-219-0357
Practice Address - Fax:817-419-2943
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301110683207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery