Provider Demographics
NPI:1124472105
Name:MCCLANAHAN, STEPHEN TAYLOR (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:TAYLOR
Last Name:MCCLANAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 PRESERVE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4702
Mailing Address - Country:US
Mailing Address - Phone:205-987-4444
Mailing Address - Fax:205-987-4464
Practice Address - Street 1:5295 PRESERVE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4702
Practice Address - Country:US
Practice Address - Phone:205-987-4444
Practice Address - Fax:205-987-4464
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL36658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program