Provider Demographics
NPI:1295299527
Name:CARTER, CLAYTON J (PHARMD)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:J
Last Name:CARTER
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8212
Mailing Address - Country:US
Mailing Address - Phone:435-225-6706
Mailing Address - Fax:
Practice Address - Street 1:3489 W 2100 S STE 350
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-5897
Practice Address - Country:US
Practice Address - Phone:385-324-2508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7069676-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist