Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 2739 | OH |
NPI | 1861616658 |
---|---|
Provider Name | Courtney Arron Mcclure |
First Address | Kingston, OH 45644-0646 |
Second Address | Kingston, OH 45644-0646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2160870 | (05) | OH |
22000000162917 | ABSC (01) | OH |
2450629 | AETNA (01) | OH |
4497404 | UNITED HEALTHCARE INSUR (01) | OH |