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General NPI Number Information
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NPI Number | 1285715243
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Entity Type | Organization
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Legal Business Name | CLAYTON HEALTH SYSTEMS INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 314 N 3RD AVE
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City | CLAYTON
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State | NM
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Zip | 88415-3302
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Country | US
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Telephone | 505-374-2273
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Fax | 505-374-0903
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Provider Business Mailing Address
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Address Line | PO BOX 489
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City | CLAYTON
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State | NM
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Zip | 88415-0489
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Country | US
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Telephone | 505-374-2585
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Fax | 505-374-0903
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Authorized Official
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Title or Position | CEO
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Name | TAMMIE CHAVEZ
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Credential |
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Telephone | 575-347-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 3060
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License Number State | NM
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