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General NPI Number Information
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NPI Number | 1437262573
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Entity Type | Individual
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Provider Name | TIMOTHY PATRICK MCCLURE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 8 SHACKLEFORD PLZ STE 207
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1853
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Country | US
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Telephone | 501-224-7191
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 FOXCROFT RD
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City | LITTLE ROCK
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State | AR
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Zip | 72227-2330
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Country | US
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Telephone | 501-414-0089
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | E-5001
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T2006-117
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License Number State | AR
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