Individual
CLAYTON A FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1791 ALUM CREEK DR STE 100, COLUMBUS, OH 43207-1708
(614) 645-2300
(614) 645-2333
Mailing address
2780 AIRPORT DR STE 100, COLUMBUS, OH 43219-2289
(614) 859-1906
(614) 645-5517
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.392650
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
022933
OH
Other
Enumeration date
06/26/2018
Last updated
11/21/2018
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