Provider Demographics
NPI:1326307752
Name:MCCLURE, SCOTT CRAWFORD (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:CRAWFORD
Last Name:MCCLURE
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 1:3433 N HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-1647
Mailing Address - Country:US
Mailing Address - Phone:314-720-4380
Mailing Address - Fax:314-720-4381
Practice Address - Street 1:3433 N HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-1647
Practice Address - Country:US
Practice Address - Phone:314-720-4380
Practice Address - Fax:314-720-4381
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8507207P00000X
390200000X
MO2021039737207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program