Healthcare Provider Details

I. General information

NPI: 1306839840
Provider Name (Legal Business Name): ELLEN ELIZABETH CLAXTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S WILLARD ST STE 101
COTTONWOOD AZ
86326-4126
US

IV. Provider business mailing address

PO BOX 3630
FLAGSTAFF AZ
86003-3630
US

V. Phone/Fax

Practice location:
  • Phone: 928-634-2015
  • Fax:
Mailing address:
  • Phone: 928-233-5110
  • Fax: 928-774-6687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD60426326
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number23433
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: