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NPI Code Detail

MEDICARE: DR. JOEL CHARLES MCCLURG MD, PHD, FAAOS

MEDICARE:  DR. JOEL CHARLES MCCLURG  MD, PHD, FAAOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician264649NY
2207X00000XOrthopaedic Surgery Physician01081382AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2014P9OTHERNCBCBS

General Provider Information

NPI Number : 1194914812
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOEL CHARLES MCCLURG MD, PHD, FAAOS
Provider Business Mailing Address
First Line : 108 AUSTIN LN
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-1789
Country : US
Telephone Number : 607-438-8115
Fax Number :
Provider Business Practice Location Address
First Line : 108 AUSTIN LN
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-1789
Country : US
Telephone Number : 607-438-8115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2007
Last Update Date : 10/30/2023

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Directions to “ DR. JOEL CHARLES MCCLURG MD, PHD, FAAOS” Practice Location

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