Healthcare Provider Details

I. General information

NPI: 1275450074
Provider Name (Legal Business Name): MADISON MCCLURE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 E 6TH ST
WHITEFISH MT
59937-2774
US

IV. Provider business mailing address

1525 HILLCREST DR
SHERIDAN WY
82801-4037
US

V. Phone/Fax

Practice location:
  • Phone: 406-862-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-OPT-LIC-6008
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: