Provider Demographics
NPI:1215170667
Name:MCCREADY, JOESPH L (MD)
Entity type:Individual
Prefix:
First Name:JOESPH
Middle Name:L
Last Name:MCCREADY
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 1:310 N WILMOT RD
Mailing Address - Street 2:STE 105
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2618
Mailing Address - Country:US
Mailing Address - Phone:520-886-3800
Mailing Address - Fax:520-886-2250
Practice Address - Street 1:310 N WILMOT RD
Practice Address - Street 2:STE 105
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2618
Practice Address - Country:US
Practice Address - Phone:520-886-3800
Practice Address - Fax:520-886-2250
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61761744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study