Basic Information
| Provider Information | |||||||||
| NPI: | 1306007083 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCLURE | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4925 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503054925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156438677 | ||||||||
| FaxNumber: | 5156438316 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 6TH AVE | ||||||||
| Address2: | MAIN 3 | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503142613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156438677 | ||||||||
| FaxNumber: | 5156438316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 06/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | R-8414 | IA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 4113 | IA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.