Clayton Mobile Diagnostic Clinic

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

CLAYTON MOBILE DIAGNOSTIC CLINIC

Practice address

6911 Tara Blvd
Jonesboro, GA 30236-1503

Phone

(770) 477-9535

Fax

(770) 471-7826

NPI assigned

Jun 30, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stanley Kalish, DPM

Title

President

Phone

(770) 477-9535

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396742870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 TARA BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361503",
            "telephone_number": "770-477-9535",
            "fax_number": "770-471-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 TARA BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361503",
            "telephone_number": "770-477-9535",
            "fax_number": "770-471-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON MOBILE DIAGNOSTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KALISH",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-477-9535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Mhddad
• Clayton Mhddad
• Clayton Mhddad
• Clayton Mhddad
• Clayton Mhddad
• Clayton Outpatient Surgical Center
• Cassandra Clayton
• Teresa Cleaves, CSA
• Desiree Clement, CNM
• Roza Elena Clempus, M.D.

• Podiatrist in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.