Provider Demographics
NPI:1043705866
Name:MCCLEVE, JEFFERY (PA-C)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:
Last Name:MCCLEVE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:5334 S WOODROW ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5838
Mailing Address - Country:US
Mailing Address - Phone:801-284-1702
Mailing Address - Fax:801-266-7116
Practice Address - Street 1:5323 S WOODROW ST STE 100
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5842
Practice Address - Country:US
Practice Address - Phone:801-713-0600
Practice Address - Fax:801-266-7116
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant