Organization
SR BILLING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BO E MCCLAIN MD (OWNER)
(623) 974-9571
Entity
Organization
Contact information
Practice address
12361 W BOLA DR, SUITE 109, SURPRISE, AZ 85378
(623) 974-9571
Mailing address
12361 W BOLA DR, SUITE 109, SURPRISE, AZ 85378
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
AZ
Other
Enumeration date
05/17/2012
Last updated
05/17/2012
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