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CLAYTOR MEMORIAL CLINIC NPI 1720453905


NPI Information

NPI: 1720453905
Provider Name: CLAYTOR MEMORIAL CLINIC
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Organization

Specialization: Child & Adolescent Psychiatry

Address:
1625 FRANKLIN ST
ROCKY MOUNT, VA
ZIP 24151
Phone: (844) 543-9362
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CLAYTOR MEMORIAL CLINIC is a child and adolescent psychiatry psychiatry neurology in Rocky Mount, VA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. CLAYTOR MEMORIAL CLINIC NPI is 1720453905. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1625 FRANKLIN ST
ROCKY MOUNT, VA
ZIP 24151-390
Phone: (844) 543-9362

The provider's authorized official is Richard Lamont Claytor .
The authorized official title is Owner and has the following contact phone number (540) 598-6321.

The enumeration date for this NPI number is 12/14/2015 and was last updated on 12/14/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry0101055727VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11376633610MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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