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1326231937 NPI number — JOHN LARSEN CLAYTON M.D.

NPI Number: 1326231937
Health Care Provider/Practitioner: JOHN LARSEN CLAYTON M.D.

Information about “1326231937” NPI (JOHN LARSEN CLAYTON M.D.) exists in 1326231937 in HTML format HTML  |  1326231937 in plain Text format TXT  |  1326231937 in PDF (Portable Document Format) PDF  |  1326231937 in an XML format XML  formats.

NPI Number : 1326231937 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326231937",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CLAYTON",
    "FirstName": "JOHN",
    "MiddleName": "LARSEN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 27128",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SALT LAKE CITY",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84127-0128",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-285-4600",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3723 W 12600 S STE 270",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIVERTON",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84065-7296",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-285-4600",
    "PracticeLocationAddressFaxNumber": "801-285-4601",
    "EnumerationDate": "08/27/2007",
    "LastUpdateDate": "07/02/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": "A99699",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208200000X",
          "TaxonomyName": "Plastic Surgery Physician",
          "LicenseNumber": "8565087-1205",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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