1295860112 NPI number — DR. DONALD ALEXANDER CLAXTON M.D.

Table of content: DR. DONALD ALEXANDER CLAXTON M.D. (NPI 1295860112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295860112 NPI number — DR. DONALD ALEXANDER CLAXTON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLAXTON
Provider First Name:
DONALD
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295860112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
865 MERRICK RD
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
BALDWIN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11510-3338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-442-4728
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 MASON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEMPSTEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11550-6621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-262-4925
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  159980 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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