Provider Demographics
NPI:1649700378
Name:MILLER, CLAYTON MORRIS (PA-C)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:MORRIS
Last Name:MILLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 US HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3378
Mailing Address - Country:US
Mailing Address - Phone:912-350-7020
Mailing Address - Fax:912-459-0064
Practice Address - Street 1:3780 US HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3378
Practice Address - Country:US
Practice Address - Phone:912-350-7020
Practice Address - Fax:912-459-0064
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2789363A00000X
GA8374363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant