Healthcare Provider Details

I. General information

NPI: 1457886129
Provider Name (Legal Business Name): LAUREN ASHLEY MCCLAIREN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 PRIMACY PKWY STE 400
MEMPHIS TN
38119-5704
US

IV. Provider business mailing address

6060 PRIMACY PKWY STE 400
MEMPHIS TN
38119-5704
US

V. Phone/Fax

Practice location:
  • Phone: 901-472-4293
  • Fax: 901-472-9536
Mailing address:
  • Phone: 901-472-4293
  • Fax: 901-472-9536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number63605
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number63605
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: