Individual
DR. CHARLES DURRELL CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
152 N TITMUS DR, MASTIC, NY 11950-1818
(631) 871-6945
Mailing address
152 N TITMUS DR, MASTIC, NY 11950-1818
(631) 871-6945
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00910178
—
NY
Enumeration date
12/28/2006
Last updated
07/08/2007
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