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NPI Code Detail

MEDICARE: DR. EMILY MARIE MCCLURE M.D.

MEDICARE: DR. EMILY MARIE MCCLURE M.D.
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
1207Q00000XFamily Medicine PhysicianMD.21689AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00093289OTHERALRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1051517978OTHERALBC BS C PLUS
2200284020OTHERALTRICARE
3051517978OTHERALBLUE ADVANTAGE
5051517978OTHERALBLUECROSS BLUESHIELD, AL2
620028402035601A001OTHERALTRICARE FOR LIFE
7051517978OTHERALBLUECROSS BLUESHIELD, AL
820028402035601A001OTHERALTRICARE

General Provider Information

NPI Number : 1144341306
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY MARIE MCCLURE M.D.
Provider Business Mailing Address
First Line : 1201 SOMERVILLE RD SE
Second Line :
City : DECATUR
State : AL
Zip : 35601-4340
Country : US
Telephone Number : 256-355-1216
Fax Number : 256-355-1655
Provider Business Practice Location Address
First Line : 1201 SOMERVILLE RD SE
Second Line :
City : DECATUR
State : AL
Zip : 35601-4340
Country : US
Telephone Number : 256-355-1216
Fax Number : 256-355-1655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 10/28/2013

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