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1316366818

NPI Code Detail

MEDICARE: DR. CLAYTON WARREN COMMANDER M.D., PH.D.

MEDICARE: DR. CLAYTON WARREN COMMANDER M.D., PH.D.

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	2085R0204X	Vascular & Interventional Radiology Physician	200889	NC
2	2085R0202X	Diagnostic Radiology Physician	200889	NC
3	2085R0204X	Vascular & Interventional Radiology Physician	99280	GA
4	2085R0204X	Vascular & Interventional Radiology Physician	ME163224	FL
5	2085R0204X	Vascular & Interventional Radiology Physician	0101286584	VA
6	2085R0202X	Diagnostic Radiology Physician	99280	GA

General Provider Information

NPI Number	:	1316366818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAYTON WARREN COMMANDER M.D., PH.D.

Provider Business Mailing Address
First Line	:	8375 DIX ELLIS TRL STE 201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-8241
Country	:	US
Telephone Number	:	904-399-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	8375 DIX ELLIS TRL STE 201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-8241
Country	:	US
Telephone Number	:	904-399-5810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2014
Last Update Date	:	11/05/2025

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Directions to “ DR. CLAYTON WARREN COMMANDER M.D., PH.D.” Practice Location

Language	Start Address	Practice Location

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