Healthcare Provider Details

I. General information

NPI: 1891774329
Provider Name (Legal Business Name): CLAYTON MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S ELM AVE
SAINT LOUIS MO
63119-3845
US

IV. Provider business mailing address

520 S ELM AVE
SAINT LOUIS MO
63119-3845
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-4434
  • Fax: 314-645-3801
Mailing address:
  • Phone: 314-645-4434
  • Fax: 314-645-3801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN J BUDD III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 314-645-4434