Van Allen Clayton, PHARMD
Individual provider
Active NPI
Pharmacist · Walnut Ridge, AR
NPI 1558098210 · NPPES record last updated Aug 3, 2022
Key facts
- NPI
- 1558098210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PD08346 (AR)
- Practice address
- 1208 W Main St
Walnut Ridge, AR 72476-1005
- Phone
- (870) 886-8100
- Fax
- (870) 886-9200
- NPI assigned
- Aug 3, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|
| PD08346 | AR | MD | Pharmacist |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Pharmacist |
183500000X |
PD08346 |
AR |
Yes |
Addresses
Primary practice location
1208 W Main St
Walnut Ridge, AR 72476-1005
Mailing address
124 Charleston Dr
Walnut Ridge, AR 72476-8552
Phone (870) 637-2162
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| PD08346 | Other | AR | STATE LICENSE NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|
| Direct Messaging Address |
fcp1208@sbcglobal.net |
|
Family Clinic Pharmacy, LLC |
Other providers in Walnut Ridge, AR
- Mary E Cain, LPC
- Carl Stanley Duckworth P a
- Derek J Cashmer, PT
- Bethany Clark, MS,CCC-SLP
- Clayton Dirk Davis
- Ronda Lee Clements, APN
- John Edward Coates, MD
- Misty Dawn Colvey, ATC, LAT
- Complete Healing Chiropractic, PLLC.
- Shannon Swift Cooper, M.D.
All providers in Walnut Ridge, AR
· Pharmacist in Arkansas