Individual
DONALD EUGENE CLAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
01026209A
IN
207KA0200X
Allergy Physician
01026209A
IN
207R00000X
Internal Medicine Physician
01026209A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189458
ANTHEM PROVIDER NUMBER
IN
05
—
100231520
—
IN
01
—
10824916
CAQH NUMBER
IN
01
—
9396966
PHCS PID NUMBER
IN
05
—
CL80529003
—
IN
Enumeration date
03/15/2006
Last updated
06/15/2021
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