MEDICARE: STEPHEN M MCCLAIN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	2537	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013913151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN M MCCLAIN PA-C

Provider Business Mailing Address
First Line	:	11951 E CORONADO RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-8985
Country	:	US
Telephone Number	:	520-760-8980
Fax Number	:

Provider Business Practice Location Address
First Line	:	13101 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85739-9554
Country	:	US
Telephone Number	:	520-818-2018
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

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