Doctor Name: | DR. MARC ANTHONY CLANTON |
NPI Number: | 1538190921 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 870 |
Business Practice Address: | N.e. 115 Old Town Road Anadarko, OK - 73005 |
Business Phone Number: | 4052472458 |
Business Fax Number: | 4052476653 |
Mailing Address: | N.e. 115 Old Town Road, Indian Health Center ANADARKO |
State: | OK |
Postal Code: | 73005 |
Phone Number: | 4052472458 |
Fax Number: | 4052476653 |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 870 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |