Healthcare Provider Details

I. General information

NPI: 1346313905
Provider Name (Legal Business Name): DARYN MCCLURE, M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20715 E OCOTILLO RD SUITE 102
QUEEN CREEK AZ
85142-6118
US

IV. Provider business mailing address

20715 E OCOTILLO RD SUITE 102
QUEEN CREEK AZ
85142-6118
US

V. Phone/Fax

Practice location:
  • Phone: 480-987-0987
  • Fax: 480-987-0940
Mailing address:
  • Phone: 480-987-0987
  • Fax: 480-987-0940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DARYN N MCCLURE
Title or Position: CEO
Credential: M.D.
Phone: 480-987-0987