Organization
KEITH J. CLAYTON, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY LYNNE ORD (OFFICE MANAGER)
(801) 377-4800
Entity
Organization
Contact information
Practice address
1675 N FREEDOM BLVD, STE 9C, PROVO, UT 84604
(801) 377-4800
(801) 377-4041
Mailing address
1675 N FREEDOM BLVD, STE 9C, PROVO, UT 84604
(801) 377-4800
(801) 377-4041
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
152622-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
550480776008
—
UT
Enumeration date
07/22/2011
Last updated
07/22/2011
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