Provider Demographics
NPI:1477083772
Name:MCCLURE, ALEXANDER DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:DAVID
Last Name:MCCLURE
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 1:8407 DELMAR BLVD APT 2E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2159
Mailing Address - Country:US
Mailing Address - Phone:636-667-0349
Mailing Address - Fax:
Practice Address - Street 1:851 E 5TH ST STE 112
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3128
Practice Address - Country:US
Practice Address - Phone:636-239-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017020281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist