Provider Demographics
NPI:1144832973
Name:WHITTINGTON, CLAYTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:
Last Name:WHITTINGTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:PANA
Mailing Address - State:IL
Mailing Address - Zip Code:62557-1404
Mailing Address - Country:US
Mailing Address - Phone:217-562-2770
Mailing Address - Fax:217-562-2778
Practice Address - Street 1:108 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:PANA
Practice Address - State:IL
Practice Address - Zip Code:62557-1404
Practice Address - Country:US
Practice Address - Phone:217-562-2770
Practice Address - Fax:217-562-2778
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist