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General NPI Number Information
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NPI Number | 1659672178
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Entity Type | Organization
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Legal Business Name | JOHN R MCCREARY MD INC
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 1660 E HERNDON AVE SUITE 104
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City | FRESNO
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State | CA
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Zip | 93720-3359
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Country | US
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Telephone | 559-431-9100
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Fax | 559-431-9177
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Provider Business Mailing Address
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Address Line | 1660 E HERNDON AVE SUITE 104
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City | FRESNO
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State | CA
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Zip | 93720-3359
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Country | US
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Telephone | 559-431-9100
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Fax | 559-431-9177
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Authorized Official
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Title or Position | OWNER
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Name | JOHN R MCCREARY
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Credential | MD
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Telephone | 559-431-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C29075
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License Number State | CA
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