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General NPI Number Information
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NPI Number | 1265777098
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Entity Type | Individual
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Provider Name | WILLIAM ANDREW CLAYBAUGH PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 251 MIRACLE STRIP PKWY SE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-5853
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Country | US
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Telephone | 850-796-1937
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Fax | 850-796-1950
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Provider Business Mailing Address
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Address Line | 1400 LITTLE DUCK CIR
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City | GULF BREEZE
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State | FL
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Zip | 32563-9135
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Country | US
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Telephone | 904-608-2283
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS 45489
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License Number State | FL
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