Provider Demographics
NPI:1891774329
Name:CLAYTON MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CLAYTON MEDICAL ASSOCIATES, P.C.
Other - Org Name:SAINT LOUIS RHEUMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUDD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:314-645-4434
Mailing Address - Street 1:520 S ELM AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3845
Mailing Address - Country:US
Mailing Address - Phone:314-645-4434
Mailing Address - Fax:314-645-3801
Practice Address - Street 1:520 S ELM AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-3845
Practice Address - Country:US
Practice Address - Phone:314-645-4434
Practice Address - Fax:314-645-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RR0500X, 207RR0500X
MOR3E59261QM1300X
MO36756261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSA10484Medicare UPIN
MOE64413Medicare UPIN
MOA13920Medicare UPIN
MO000013367Medicare ID - Type UnspecifiedMEDICARE NUMBER