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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700814639 NPPES
Arizona MEDICAID 945892

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