Provider Demographics
NPI:1669934857
Name:BRANTON, CLAYTON (MD)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:BRANTON
Suffix:
Gender:M
Credentials:MD
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 700
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-0700
Mailing Address - Country:US
Mailing Address - Phone:318-368-9745
Mailing Address - Fax:
Practice Address - Street 1:1025 MARION HWY
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-9314
Practice Address - Country:US
Practice Address - Phone:318-368-9745
Practice Address - Fax:318-368-1027
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330258207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine