Provider Demographics
NPI:1477668879
Name:MCCLARD, ELIZABETH R (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:R
Last Name:MCCLARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:346 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4437
Mailing Address - Country:US
Mailing Address - Phone:303-377-5914
Mailing Address - Fax:303-377-5921
Practice Address - Street 1:346 MADISON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4437
Practice Address - Country:US
Practice Address - Phone:303-377-5914
Practice Address - Fax:303-377-5921
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO42028207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85324736Medicaid
CO42028OtherLICENSE
CO42028OtherLICENSE
COI22868Medicare UPIN
COBM8531762OtherDEA #