Provider Demographics
NPI:1740279538
Name:BARCLAY, CLAYTON JR (MD)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:
Last Name:BARCLAY
Suffix:JR
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 1:14019 ECHO HILL TRL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5169
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 KINGS DAUGHTERS DR
Practice Address - Street 2:PHOENIX EMERGENCY SERVICES OF MADISON
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3300
Practice Address - Country:US
Practice Address - Phone:812-265-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33746207P00000X
IN01030792A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000612917OtherANTHEM BCBS
IN100338140Medicaid
KY64337462Medicaid
KY64337462Medicaid
IN100338140Medicaid