Healthcare Provider Details

I. General information

NPI: 1912940453
Provider Name (Legal Business Name): YOCUNDA CLAYTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BELCHER ST
CENTREVILLE AL
35042-2946
US

IV. Provider business mailing address

217 COUNTRY CLUB PARK PMB #415
MOUNTAIN BRK AL
35213-4237
US

V. Phone/Fax

Practice location:
  • Phone: 205-926-2992
  • Fax: 205-316-7675
Mailing address:
  • Phone: 205-422-0857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number26312
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: