Individual
CLAYTON JAMES KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
105 N CEDAR ST, GLEASON, TN 38229-7264
(731) 648-5634
(731) 352-4459
Mailing address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2450
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3301090
—
TN
01
—
3380640
GROUP MEDICADI
TN
05
—
Q003304
—
TN
Enumeration date
12/13/2013
Last updated
08/11/2022
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