Individual
DR. CLAYTON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, PHARM.D, PA-C
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-2000
Mailing address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-2000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
22426
NC
207P00000X
Emergency Medicine Physician
Primary
0010-07792
NC
363AM0700X
Medical Physician Assistant
0010-07792
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-07792
NC PA LICENSE NUMBER
NC
01
—
0116040824
VIRGINIA INTERN/RESIDENT LICENSE
VA
01
—
222426
NC STATE LICENSE NUMBER- PHARMACY
NC
Enumeration date
02/20/2014
Last updated
06/09/2025
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