Provider Demographics
NPI:1780704536
Name:CLAYTON PLASTIC SURGERY SPECIALISTS
Entity type:Organization
Organization Name:CLAYTON PLASTIC SURGERY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-262-5552
Mailing Address - Street 1:5770 S 250 E STE 235
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6191
Mailing Address - Country:US
Mailing Address - Phone:801-262-5552
Mailing Address - Fax:801-262-5771
Practice Address - Street 1:5770 S 250 E STE 235
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6191
Practice Address - Country:US
Practice Address - Phone:801-262-5552
Practice Address - Fax:801-262-5771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty