Healthcare Provider Details

I. General information

NPI: 1811208655
Provider Name (Legal Business Name): JASON ALLEN CLAYTON MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2010
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 JOHNSON FERRY RD
ATLANTA GA
30342-1605
US

IV. Provider business mailing address

8820 GLEN FERRY DR
JOHNS CREEK GA
30022-5371
US

V. Phone/Fax

Practice location:
  • Phone: 919-593-8584
  • Fax:
Mailing address:
  • Phone: 919-593-8584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number255079
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number245142
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number39757
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number93558
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number35.123695
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: