Healthcare Provider Details

I. General information

NPI: 1154789915
Provider Name (Legal Business Name): TOYA G CLAXTON CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2016
Last Update Date: 02/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11975 MORRIS RD
ALPHARETTA GA
30005-4419
US

IV. Provider business mailing address

8618 STONE CREEK CT
DOUGLASVILLE GA
30135-1657
US

V. Phone/Fax

Practice location:
  • Phone: 770-360-9916
  • Fax: 770-360-9937
Mailing address:
  • Phone: 404-914-3172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: