Individual provider · NPI-1

Keith Edward Clayton II

Student in an Organized Health Care Education/Training Program · Muskogee, OK

NPI number1639458029
StatusActive
Last updated in NPPESAug 16, 2011

Details

NPI
1639458029
Entity type
Individual (NPI-1)
Name
Keith Edward Clayton II
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 16, 2011
Last updated
Aug 16, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Phone 918-577-3196

Mailing address

102 York Village Dr
Apt 1
Muskogee, OK 74403-4843

Phone 918-616-4626

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