Provider Demographics
NPI:1477995199
Name:MCCLAIN, SUZANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:DRAPEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4500 W 38TH AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2005
Mailing Address - Country:US
Mailing Address - Phone:303-455-0888
Mailing Address - Fax:303-455-0300
Practice Address - Street 1:4500 W 38TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2005
Practice Address - Country:US
Practice Address - Phone:303-455-0888
Practice Address - Fax:303-455-0300
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003004152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist