MEDICARE: CLAYTON JUSTUS OVERTON III MD, MPH, MSPH, FAEEM

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	207P00000X	Emergency Medicine Physician	37535	SC
2	207P00000X	Emergency Medicine Physician	17549	MS
3	207P00000X	Emergency Medicine Physician	A96078	CA
4	207P00000X	Emergency Medicine Physician	35848	TN
5	207P00000X	Emergency Medicine Physician	13765	HI
6	207P00000X	Emergency Medicine Physician	ME119281	FL
7	207P00000X	Emergency Medicine Physician	04-37095	KS
8	207P00000X	Emergency Medicine Physician	60175689	WA
9	207P00000X	Emergency Medicine Physician	24366	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A960780	OTHER	CA	MEDI-CAL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598712135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAYTON JUSTUS OVERTON III MD, MPH, MSPH, FAEEM

Provider Business Mailing Address
First Line	:	PO BOX 1770
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70434-1770
Country	:	US
Telephone Number	:	985-893-5767
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 CLAUDIA DR
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70435-9513
Country	:	US
Telephone Number	:	985-893-5767
Fax Number	:

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	05/13/2024

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Directions to “ CLAYTON JUSTUS OVERTON III MD, MPH, MSPH, FAEEM” Practice Location

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