Individual
MR. JON RUSSELL CLAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 MEDICAL DR, BENSON, NC 27504-1177
(919) 894-1740
(919) 894-2701
Mailing address
PO BOX 839, BENSON, NC 27504-0839
(919) 894-1740
(919) 894-2701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104211
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104211
STATE LICENSE
NC
Enumeration date
05/21/2007
Last updated
10/07/2014
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