Provider Demographics
NPI:1851396543
Name:CLAYTON, THOMAS J (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-0406
Mailing Address - Country:US
Mailing Address - Phone:814-677-3881
Mailing Address - Fax:814-677-0532
Practice Address - Street 1:3230 STATE ROUTE 257
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2434
Practice Address - Country:US
Practice Address - Phone:814-677-3881
Practice Address - Fax:814-677-0532
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002999-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA207570OtherUPMC HEALTH PLAN
PA000084848OtherBLUE CROSS BLUE SHIELD
PA0011955600002Medicaid
PA000084848OtherBLUE CROSS BLUE SHIELD
PAT21855Medicare UPIN
PA350030793Medicare ID - Type UnspecifiedRAILROAD MEDICARE