Provider Demographics
NPI:1215693635
Name:EARHART, CLAYTON R (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:R
Last Name:EARHART
Suffix:
Gender:M
Credentials:PHARM D
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 528
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65066-0528
Mailing Address - Country:US
Mailing Address - Phone:573-205-1731
Mailing Address - Fax:
Practice Address - Street 1:601 EAST HWY 28
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65066-6506
Practice Address - Country:US
Practice Address - Phone:573-437-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018006738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist