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Contact Information

CLAYTON MHDDAD
217 STOCKBRIDGE RD
JONESBORO, GA30236-3628
 Phone: 770-471-4617
 Fax: 770-471-7817
 Website:
Indicates primary specialty

NPI Profile & details for CLAYTON MHDDAD

NPI # 1922296813
LBN Legal business name CLAYTON MHDDAD
Authorized official TERRY COLE - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/05/2007
Last updated 11/15/2011 - About 15 years ago
Identifiers
GA Medicaid 00395458A
GA Medicaid 00604205G
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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