Provider Demographics
NPI:1154452233
Name:MCCLEERY, RAYMOND CLYDE (OD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CLYDE
Last Name:MCCLEERY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5075 LEETSDALE DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8176
Mailing Address - Country:US
Mailing Address - Phone:303-333-2800
Mailing Address - Fax:303-394-2544
Practice Address - Street 1:5075 LEETSDALE DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8176
Practice Address - Country:US
Practice Address - Phone:303-333-2800
Practice Address - Fax:303-394-2544
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT 1319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist