Provider Demographics
NPI:1225237472
Name:MCCLURG, MARY K (CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:K
Last Name:MCCLURG
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 722
Mailing Address - Street 2:AA HIGHWAY
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-0722
Mailing Address - Country:US
Mailing Address - Phone:606-796-3378
Mailing Address - Fax:606-796-3378
Practice Address - Street 1:AA HIGHWAY
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179
Practice Address - Country:US
Practice Address - Phone:606-796-3378
Practice Address - Fax:606-796-3378
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator