MEDICARE: BRIAN CLAYTON PA-C

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	363AS0400X	Surgical Physician Assistant	5601003935	MI

General Provider Information

NPI Number	:	1396865127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CLAYTON PA-C

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18101 OAKWOOD BLVD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-4089
Country	:	US
Telephone Number	:	313-982-5440
Fax Number	:

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	04/14/2026

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