Individual
DOUGLAS E CLAYBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3130
(812) 242-3596
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3130
(812) 242-3596
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01029167A
IN
208800000X
Urology Physician
36089198
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089642
ANTHEM
—
05
—
100250650
—
IN
05
—
100250650U
—
IN
01
—
340009236
RAILROAD MCARE PALAMETTO
—
01
—
340009242
RAILROAD MCARE PALAMETTO
—
01
—
P00828496
RAILROAD MEDICARE
IN
Enumeration date
08/23/2006
Last updated
08/18/2010
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