# CLAYTON COUNTY BOARD OF COMMISSIONERS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952858821
- **Authorized official:** MR. LANDRY DOYLE MERKISON (FIRE CHIEF / EMS DIRECTOR)
- **Authorized official phone:** (770) 473-3831

## Contact information

- **Practice address:** 7810 HIGHWAY 85, RIVERDALE, GA 30274-3920
- **Practice address phone:** (770) 473-3831
- **Practice address fax:** (770) 473-3837
- **Mailing address:** 112 SMITH ST, JONESBORO, GA 30236-3539
- **Mailing address phone:** (770) 473-3831
- **Mailing address fax:** (770) 473-3837

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2016
- **Last updated:** 03/01/2017