MEDICARE: SCOTT CRAWFORD 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
1	207P00000X	Emergency Medicine Physician	P8507	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207P00000X	Emergency Medicine Physician	2021039737	MO

General Provider Information

NPI Number	:	1326307752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT CRAWFORD MCCLURE M.D.

Provider Business Mailing Address
First Line	:	3433 N HIGHWAY 67
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-1647
Country	:	US
Telephone Number	:	314-720-4380
Fax Number	:	314-720-4381

Provider Business Practice Location Address
First Line	:	3433 N HIGHWAY 67
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-1647
Country	:	US
Telephone Number	:	314-720-4380
Fax Number	:	314-720-4381

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

Provider Enumeration Date	:	05/04/2012
Last Update Date	:	11/05/2024

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