Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2007013977 | MO |
Y | 208600000X | Surgeon | 2007013977 | MO |
N | 208200000X | Surgeon | 36034 | AZ |
N | 208600000X | Surgeon | 36034 | AZ |
N | 2086S0102X | Surgical Critical Care | 36034 | AZ |
N | 2086S0127X | Trauma Surgeon | 2007013977 | MO |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 2007013977 | MO |
NPI | 1073564985 |
---|---|
Provider Name | Dr. Joseph M Mcclain |
First Address | Kansas City, MO 64180-1143 |
Second Address | Cape Girardeau, MO 63703-5095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 22/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
315276 | (05) | AZ |
H98352 | (02) |