Provider Demographics
NPI:1851398788
Name:DICK, CLAYTON BEAUMAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:BEAUMAN
Last Name:DICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 COUNTY HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-3007
Mailing Address - Country:US
Mailing Address - Phone:615-687-2568
Mailing Address - Fax:
Practice Address - Street 1:1412 COUNTY HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3007
Practice Address - Country:US
Practice Address - Phone:615-687-2568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14780183500000X
GARPH022081183500000X
TN27477183500000X, 183500000X
OHRPH.03331519-3183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4241768OtherBLUE CROSS / BLUE SHIELD OF TENNESSEE