IndividualActive
Clay Cornelison, DO
NPI 1609454040 · Psychiatry Physician · Pocatello, ID
Provider details
- NPI number
- 1609454040
- Entity type
- Individual
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 222123 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
500 S 11th Ave
Pocatello, ID 83201-4835
Phone: (208) 232-6214
Approximate (ZIP-level) locationGet directions
Mailing address
500 S 11th Ave
Pocatello, ID 83201-4835
Registry dates
- Enumerated
- 2021-03-29
- Last updated
- 2026-02-24
- Certified
- 2026-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.