Provider Demographics
NPI:1821118134
Name:CLAYTON, DAVID N (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9450 S 1300 E
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-5555
Mailing Address - Country:US
Mailing Address - Phone:801-501-6250
Mailing Address - Fax:801-501-6260
Practice Address - Street 1:9450 S 1300 E
Practice Address - Street 2:SUITE 220
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-5555
Practice Address - Country:US
Practice Address - Phone:801-501-6250
Practice Address - Fax:801-501-6260
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT161445-12052086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD20197Medicare UPIN
UT000001339Medicare PIN