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General NPI Number Information
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NPI Number | 1447575287
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Entity Type | Organization
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Legal Business Name | STACEY D MCCLURE MD PLLC
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 9250 N 3RD ST STE 4030
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City | PHOENIX
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State | AZ
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Zip | 85020-2437
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Country | US
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Telephone | 602-944-2271
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Fax | 602-943-3420
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Provider Business Mailing Address
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Address Line | 9250 N 3RD ST STE 4030
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City | PHOENIX
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State | AZ
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Zip | 85020-2437
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Country | US
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Telephone | 602-944-2271
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Fax | 602-943-3420
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | STACEY D MCCLURE
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Credential | MD
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Telephone | 602-944-2271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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