Provider Demographics
NPI:1861934002
Name:CLAYTON, TIFFANY L (DPT)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:L
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35046-1200
Mailing Address - Country:US
Mailing Address - Phone:205-280-6450
Mailing Address - Fax:205-280-6451
Practice Address - Street 1:110 BAKER AVE
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2337
Practice Address - Country:US
Practice Address - Phone:205-280-6450
Practice Address - Fax:205-280-6451
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH81292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-85227OtherBLUE CROSS BLUE SHEILD NUMBER
AL511-85227OtherBLUE CROSS BLUE SHEILD NUMBER