Individual
DR. CLAY A CANADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(920) 831-5050
(920) 738-6400
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036085694
IL
207X00000X
Orthopaedic Surgery Physician
Primary
47614
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020035406
COMMERICAL
IL
05
—
036085694
—
IL
01
—
3160469678
BCBS
IL
01
—
450030820
MEDICARE PTAN
WI
01
—
711290217
MEDICARE PTAN
WI
Enumeration date
03/29/2006
Last updated
08/12/2014
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