Provider Demographics
NPI:1225092349
Name:MCCLAIN, CRAIG J (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:J
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0320
Mailing Address - Fax:502-588-0326
Practice Address - Street 1:401 E CHESTNUT ST
Practice Address - Street 2:SUITE 310
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5700
Practice Address - Country:US
Practice Address - Phone:502-584-8563
Practice Address - Fax:502-562-6196
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2017-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY22402207RG0100X, 207RI0008X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64244025Medicaid
KYC65913Medicare UPIN
KY1366623Medicare PIN