Provider Demographics
NPI:1457466989
Name:CLAXTON, MATTHEW J (DPM)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:CLAXTON
Suffix:
Gender:
Credentials:DPM
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 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-5298
Mailing Address - Fax:888-824-2176
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV SURG ACCS
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-5298
Practice Address - Fax:888-824-2176
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003013610213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO309013308Medicaid
MO309013308Medicaid
MOP00171525OtherRAILROAD MEDICARE
ILK02926Medicare PIN
ILU97876Medicare UPIN
IL016005131Medicaid
IL5031350002Medicare NSC
MO246114113Medicare PIN