Mcclure, Stacey Dale
Mcclure, Stacey Dale is an sole proprietor health care provider with primary practice located at 2730 W Agua Fria Fwy Ste 103 , Phoenix AZ 85027-7202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Mcclure, Stacey Dale can be contacted via phone (480) 699-2472.Contact Information
Primary practice address
2730 W Agua Fria Fwy Ste 103
Phoenix AZ 85027-7202
Phone: (480) 699-2472
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 34081 | Arizona |
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 34081 | Arizona |
Profile Details
NPI number | 1700814639 |
---|---|
LBN Legal business name | Mcclure, Stacey Dale |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 29th, 2006 |
Last updated | Jul 9th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700814639 | NPPES |
Arizona | MEDICAID | 945892 |
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