Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SUDAN MEDICAL CLINIC, LLC
Active
Organization
SUDAN MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK LEE MCCLANAHAN D.O. (PRESIDENT/PHYSICIAN)
(806) 227-2292
Entity
Organization
Contact information
Practice address
408 E US HWY 84, SUDAN, TX 79371
(806) 227-2292
(806) 227-2293
Mailing address
PO BOX 119, SUDAN, TX 79371-0119
(806) 227-2292
(806) 227-2293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H4531
TX
261QR1300X
Rural Health Clinic/Center
—
—
363A00000X
Physician Assistant
Primary
PA02006
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074NH
BLUE CROSS BLUE SHIELD
TX
01
—
00963Z
MEDICARE
—
01
—
118927111
FIRST CARE
TX
01
—
137527
SUPERIOR HEALTH PLAN
TX
05
—
178241901
—
TX
05
—
178241902
—
TX
01
—
5594300001
PALMETTO GBA
TX
01
—
673950
MEDICARE
TX
01
—
673951
MEDICARE
TX
Enumeration date
07/30/2006
Last updated
04/12/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up