Healthcare Provider Details

I. General information

NPI: 1558335281
Provider Name (Legal Business Name): JAMES EMERY CLAYTOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 ALPINE CIRCLE
COLUMBIA SC
29223
US

IV. Provider business mailing address

125 ALPINE CIRCLE
COLUMBIA SC
29223
US

V. Phone/Fax

Practice location:
  • Phone: 803-779-3548
  • Fax: 803-779-7055
Mailing address:
  • Phone: 803-779-3548
  • Fax: 803-779-7055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberSC017268
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: