Provider Demographics
NPI:1912529090
Name:PRESTON, CLAYTON (DO)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:PRESTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 HARMONY PARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS NATIONAL PARK
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5404
Mailing Address - Country:US
Mailing Address - Phone:501-881-4988
Mailing Address - Fax:501-881-4755
Practice Address - Street 1:128 HARMONY PARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS NATIONAL PARK
Practice Address - State:AR
Practice Address - Zip Code:71913-5404
Practice Address - Country:US
Practice Address - Phone:501-881-4988
Practice Address - Fax:501-881-4755
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty