Provider Demographics
NPI:1346971280
Name:WILLIAMS, CLAYTON GRAY (DMS, PA-C)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:GRAY
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:DMS, PA-C
Other - Prefix:MR
Other - First Name:CLAYTON
Other - Middle Name:GRAY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:6010 E W T HARRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4084
Mailing Address - Country:US
Mailing Address - Phone:704-208-4134
Mailing Address - Fax:
Practice Address - Street 1:6010 E W T HARRIS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4084
Practice Address - Country:US
Practice Address - Phone:704-208-4134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001014419363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program