| Doctor Name: | CLAYTON BOSSIER |
| NPI Number: | 1730128166 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | N.P. |
| License Number: | AP04056 |
| Business Practice Address: | 144 W 134th St Cut Off, LA - 703454155 |
| Business Phone Number: | 9856326233 |
| Business Fax Number: | 9856327526 |
| Mailing Address: | 144 W 134th St, CUT OFF |
| State: | LA |
| Postal Code: | 703454155 |
| Phone Number: | 9856326233 |
| Fax Number: | 9856327526 |
| NPI Enumeration Date: | 06/04/2006 |
| NPI Last Update Date: | 08/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP04056 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |