Provider Demographics
NPI:1780143883
Name:PALMER, NATHANIEL CLAYTON (MD)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:CLAYTON
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:800-994-0371
Mailing Address - Fax:254-771-8407
Practice Address - Street 1:2401 SOUTH 31ST STREET, MS-S2-663 TEMPLE, TEXAS 76508
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508
Practice Address - Country:US
Practice Address - Phone:254-771-8411
Practice Address - Fax:254-771-8407
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine