Individual
DR. TIMOTHY M MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-2345
Mailing address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-2345
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01027823A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092678
ANTHEM PROVIDER #
IN
05
—
100117270A
—
IN
01
—
300084378
TRAVELERS MEDICARE #
IN
Enumeration date
07/22/2005
Last updated
12/21/2016
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