MEDICARE: MR. STEPHEN ANTHONY MCCLARY 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	50	MT

General Provider Information

NPI Number	:	1831163047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN ANTHONY MCCLARY PA-C

Provider Business Mailing Address
First Line	:	3511 1ST AVE N
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3527
Country	:	US
Telephone Number	:	406-727-5778
Fax Number	:	406-761-7117

Provider Business Practice Location Address
First Line	:	3511 1ST AVE N
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3527
Country	:	US
Telephone Number	:	406-727-5778
Fax Number	:	406-761-7117

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	12/20/2010

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Directions to “ MR. STEPHEN ANTHONY MCCLARY PA-C” Practice Location

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