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NPI Code Detail

MEDICARE: KENNETH MCCLURE RRT

MEDICARE: KENNETH MCCLURE RRT
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
1227900000XRegistered Respiratory TherapistRC46OK

General Provider Information

NPI Number : 1457209181
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH MCCLURE RRT
Provider Business Mailing Address
First Line : 14961 JORDAN CT
Second Line :
City : GLENPOOL
State : OK
Zip : 74033-6008
Country : US
Telephone Number : 918-577-3048
Fax Number :
Provider Business Practice Location Address
First Line : 1011 HONOR HEIGHTS DR
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-1318
Country : US
Telephone Number : 918-577-3048
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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