Provider Demographics
NPI:1467548677
Name:MCLARIO, DAVID JONATHAN (DO, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JONATHAN
Last Name:MCLARIO
Suffix:
Gender:M
Credentials:DO, MS
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:126 SMOKE HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-2881
Mailing Address - Country:US
Mailing Address - Phone:540-508-4305
Mailing Address - Fax:
Practice Address - Street 1:126 SMOKE HOUSE CT
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-2881
Practice Address - Country:US
Practice Address - Phone:540-508-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY034252080P0204X
VA01022046582080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201049700Medicaid
KY7100195300Medicaid
KY7100195300Medicaid
KYK028360Medicare PIN