MEDICARE: HANK CLAY JR MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	38748	NC

General Provider Information

NPI Number	:	1174729057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANK CLAY JR MD PC

Provider Business Mailing Address
First Line	:	138 N FORK NEW RIVER RD
Second Line	:
City	:	LANSING
State	:	NC
Zip	:	28643-9130
Country	:	US
Telephone Number	:	336-982-2158
Fax Number	:	336-982-3373

Provider Business Practice Location Address
First Line	:	138 N FORK NEW RIVER RD
Second Line	:
City	:	LANSING
State	:	NC
Zip	:	28643-9130
Country	:	US
Telephone Number	:	336-982-2158
Fax Number	:	336-982-3373

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HANK TUCKER CLAY JR.
Credential	:	MD
Telephone Number	:	336-982-2158

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	08/22/2020

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