Clayville, Jerry James

Clayville, Jerry James is an individual health care provider with primary practice located at 223 Phillip Morris Dr , Salisbury MD 21804-1923. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as his primary health care specialty. Clayville, Jerry James can be contacted via phone (410) 548-1747.

Contact Information

Primary practice address
223 Phillip Morris Dr Salisbury MD 21804-1923
Phone: (410) 548-1747
Fax: (410) 548-3783
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R057554 Maryland

Profile Details

NPI number 1215010939
LBN Legal business name Clayville, Jerry James
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Oct 24th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215010939 NPPES
Maryland MEDICAID 119591300

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