Provider Demographics
NPI:1497757579
Name:MCCLURE, JEFFREY B (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:B
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 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-1965
Mailing Address - Fax:614-366-2175
Practice Address - Street 1:6100 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2062
Practice Address - Country:US
Practice Address - Phone:614-293-1965
Practice Address - Fax:614-366-2175
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075411207RC0000X
OH35.076436207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2143031Medicaid
P00433150OtherRRMC
MI000000521478OtherANTHEM
MI1497757579Medicaid
433741OtherPRIORITY HEALTH
OH2143031Medicaid
7637005OtherAETNA
161955OtherGLHP
03440OtherPARAMOUNT
0604601792OtherBCBS MI
MI9980OtherHPM
MI5183807Medicaid
433741OtherPRIORITY HEALTH
OHMC4147743Medicare ID - Type Unspecified