MEDICARE: DR. TOYA DEON CLAY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	36116023	IL
2	2084P0800X	Psychiatry Physician	74682	GA

General Provider Information

NPI Number	:	1265649842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOYA DEON CLAY M.D.

Provider Business Mailing Address
First Line	:	2506 MADISON CMNS
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30360-2087
Country	:	US
Telephone Number	:	404-694-7362
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 RIVEREDGE PKWY
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4693
Country	:	US
Telephone Number	:	404-694-7362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	12/09/2019

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