Provider Demographics
NPI:1285329672
Name:MITCHELL, CLAYTON MILLER (DC)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:MILLER
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11388 PRICE RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35456-2305
Mailing Address - Country:US
Mailing Address - Phone:205-394-1061
Mailing Address - Fax:
Practice Address - Street 1:2601 12TH ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2807
Practice Address - Country:US
Practice Address - Phone:205-758-7158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor