| Organization Name: | ST CLAIR CLINIC |
| NPI Number: | 1760712061 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAYSON DAUGHERTY (OWNER) |
| Mailing Address: | 12 Cropwell Dr Pell City |
| State: | AL US |
| Postal Code: | 351287552 |
| Phone Number: | 2058140404 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2010 |
| NPI Last Update Date: | 01/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 13722 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |