Provider Demographics
NPI:1982315016
Name:RADCLIFFE, CLAYTON RAY
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:RAY
Last Name:RADCLIFFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 WILSIE RD
Mailing Address - Street 2:
Mailing Address - City:FRAMETOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26623-7117
Mailing Address - Country:US
Mailing Address - Phone:681-433-1683
Mailing Address - Fax:
Practice Address - Street 1:3017 WILSIE RD
Practice Address - Street 2:
Practice Address - City:FRAMETOWN
Practice Address - State:WV
Practice Address - Zip Code:26623-7117
Practice Address - Country:US
Practice Address - Phone:681-433-1683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant