John Paul Clay, PA

Individual provider Active NPI Medical Physician Assistant · Galax, VA

NPI 1316111024 · NPPES record last updated Apr 15, 2008

Key facts

NPI
1316111024
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
0110-002747 (VA)
Practice address
199 Hospital Dr
Suite 7
Galax, VA 24333-2454
Phone
(276) 236-5181
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14WVMDEndocrinology, Diabetes & Metabolism Physician
0110-002747VAMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110-002747 VA Yes

Addresses

Primary practice location

199 Hospital Dr
Suite 7
Galax, VA 24333-2454

Mailing address

199 Hospital Dr
Suite 7
Galax, VA 24333-2454
Phone (276) 236-5181

Other providers in Galax, VA

All providers in Galax, VA · Medical Physician Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.