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Individual

DR. DWAYNE LEE CLAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6010 LAKESIDE COMMONS DR, SUITE A, MACON, GA 31210-5779
(478) 475-9220
(478) 475-9201
Mailing address
6010 LAKESIDE COMMONS DR, SUITE A, MACON, GA 31210-5779
(478) 475-9220
(478) 475-9201

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
042215
GA
208VP0000X
Pain Medicine Physician
042215
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
042215
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00738493H
GA
Enumeration date
08/15/2006
Last updated
12/01/2009
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