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General NPI Number Information
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NPI Number | 1598712135
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Entity Type | Individual
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Provider Name | CLAYTON JUSTUS OVERTON III MD, MPH, MSPH, FAEEM
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Gender | Male
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 23 CLAUDIA DR
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City | COVINGTON
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State | LA
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Zip | 70435-9513
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Country | US
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Telephone | 985-893-5767
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1770
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City | COVINGTON
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State | LA
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Zip | 70434-1770
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Country | US
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Telephone | 985-893-5767
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 37535
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 17549
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A96078
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35848
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 13765
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License Number State | HI
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME119281
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 04-37095
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License Number State | KS
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Taxonomy #8
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 60175689
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 24366
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License Number State | LA
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