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PATRICIA CLAYTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PCP

Contact information

Practice address
1421 DALTON ST, JACKSON, MS 39204-2806
(601) 941-1949
Mailing address
1421 DALTON ST, JACKSON, MS 39204-2806
(601) 941-1949

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
81-5448170
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81-5448170
IRS INDIVIDUAL TAXPAYER INDENTIFICATION NUMBER
MS
Enumeration date
02/22/2017
Last updated
02/22/2017
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