Individual
CLAYTON WALTER GUTHRIE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007792
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175349E
—
GA
Enumeration date
07/07/2009
Last updated
06/11/2019
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