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Individual
MR. CLAYTON THOMAS
Active
Individual
MR. CLAYTON THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2058
KY
363A00000X
Physician Assistant
PA3108
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058
STATE LICENSE
KY
01
—
3108
STATE LICENSE
TN
05
—
7100405120
—
KY
05
—
Q026771
—
TN
Enumeration date
09/22/2015
Last updated
05/10/2022
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