Healthcare Provider Details

I. General information

NPI: 1700516085
Provider Name (Legal Business Name): TREY MCCLAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 HIGHWAY 65 S STE 203
CLINTON AR
72031-6678
US

IV. Provider business mailing address

PO BOX 9662
CONWAY AR
72033-9662
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-4914
  • Fax: 501-745-6374
Mailing address:
  • Phone: 501-852-1363
  • Fax: 501-852-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE-19548
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: