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NPI Code Detail

MEDICARE: MR. CLINTON MICHAEL SAXTON M.S.,CCC-SLP

MEDICARE: MR. CLINTON MICHAEL SAXTON M.S.,CCC-SLP
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
1235Z00000XSpeech-Language Pathologist1174AZ

General Provider Information

NPI Number : 1215916820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CLINTON MICHAEL SAXTON M.S.,CCC-SLP
Provider Business Mailing Address
First Line : 38418 N 12TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85086-4802
Country : US
Telephone Number : 623-465-5489
Fax Number :
Provider Business Practice Location Address
First Line : 1802 W PARKSIDE LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-1322
Country : US
Telephone Number : 602-943-5472
Fax Number : 602-943-4936
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 11/03/2008

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