Healthcare Provider Details

I. General information

NPI: 1669638623
Provider Name (Legal Business Name): KRISTIN MARIE MCCLAY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN MARIE SMITH

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 S MAIN ST STE 5-11
ORRVILLE OH
44667-2291
US

IV. Provider business mailing address

PO BOX 80690
CANTON OH
44708-0690
US

V. Phone/Fax

Practice location:
  • Phone: 330-684-2015
  • Fax: 330-684-2075
Mailing address:
  • Phone: 330-363-7444
  • Fax: 330-363-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.010303
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: