Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 31631 | MO |
NPI | 1003133398 |
---|---|
Provider Name | Dr. Byron D Mcclure II |
First Address | Cameron, MO 64429-0151 |
Second Address | Cameron, MO 64429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2010 |
Last Update Date | 26/04/2010 |