Individual
VAN ALLEN CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1208 W MAIN ST, WALNUT RIDGE, AR 72476-1005
(870) 886-8100
(870) 886-9200
Mailing address
124 CHARLESTON DR, WALNUT RIDGE, AR 72476-8552
(870) 637-2162
(870) 886-9200
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD08346
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD08346
STATE LICENSE NUMBER
AR
Enumeration date
08/03/2022
Last updated
08/03/2022
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