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General NPI Number Information
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NPI Number | 1992772446
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Entity Type | Individual
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Provider Name | BOELDRIDGE MCCLAIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 1266 E CAROLINE LN
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City | TEMPE
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State | AZ
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Zip | 85284-3363
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Country | US
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Telephone | 623-512-3893
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Fax |
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Provider Business Mailing Address
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Address Line | 1266 E CAROLINE LN
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City | TEMPE
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State | AZ
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Zip | 85284-3363
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Country | US
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Telephone | 623-512-3893
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 14954
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 30909
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 30909
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 30909
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 061624
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 44175
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301093420
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME102957
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License Number State | FL
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