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General NPI Number Information
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NPI Number | 1669511929
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Entity Type | Individual
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Provider Name | CHAD A MCCLAIN CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 1874 BELTLINE RD SW
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City | DECATUR
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State | AL
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Zip | 35601-5514
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Country | US
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Telephone | 256-301-3340
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Fax | 256-301-3444
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Provider Business Mailing Address
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Address Line | 3010 W CHAPEL HILL RD
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City | DECATUR
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State | AL
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Zip | 35603-4020
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Country | US
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Telephone | 256-318-8155
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1-103929
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License Number State | AL
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