Provider Demographics
NPI:1811918915
Name:CLAYTON, JEFFERY E (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:E
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3613 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-6848
Mailing Address - Country:US
Mailing Address - Phone:870-268-0053
Mailing Address - Fax:
Practice Address - Street 1:JONESBORO ANESTHESIA, INC.
Practice Address - Street 2:221 HUGHES, SUITE C
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-932-4211
Practice Address - Fax:870-931-9141
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4830207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI26460Medicare UPIN