MEDICARE: MR. W. CLAYTON BUIE JR. OTR

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	225X00000X	Occupational Therapist	502	AL
2	225X00000X	Occupational Therapist	635	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	515-30449	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1437263266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. W. CLAYTON BUIE JR. OTR

Provider Business Mailing Address
First Line	:	9702 WELCH CIR SE
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35803-2622
Country	:	US
Telephone Number	:	256-880-8075
Fax Number	:	256-650-5041

Provider Business Practice Location Address
First Line	:	245 CAHABA VALLEY PKWY
Second Line	:	SUITE 200
City	:	PELHAM
State	:	AL
Zip	:	35124-2216
Country	:	US
Telephone Number	:	205-942-6820
Fax Number	:	205-942-5627

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. W. CLAYTON BUIE JR. OTR” Practice Location

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