Individual
MR. JOHN CLAYTON CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1502 N THORNTON AVE, DALTON, GA 30720-3064
(706) 278-9729
(706) 226-9378
Mailing address
PO BOX 1207, DALTON, GA 30722-1207
(706) 278-9729
(706) 226-9378
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
023575
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00248245F
—
GA
Enumeration date
12/16/2005
Last updated
11/02/2011
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