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General NPI Number Information
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NPI Number | 1952858821
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Entity Type | Organization
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Legal Business Name | CLAYTON COUNTY BOARD OF COMMISSIONERS
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 7810 HIGHWAY 85
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City | RIVERDALE
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State | GA
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Zip | 30274-3920
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Country | US
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Telephone | 770-473-3831
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Fax | 770-473-3837
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Provider Business Mailing Address
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Address Line | 112 SMITH ST
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City | JONESBORO
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State | GA
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Zip | 30236-3539
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Country | US
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Telephone | 770-473-3831
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Fax | 770-473-3837
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Authorized Official
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Title or Position | FIRE CHIEF / EMS DIRECTOR
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Name | MR. LANDRY DOYLE MERKISON
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Credential |
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Telephone | 770-473-3831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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