Provider Demographics
NPI:1578762282
Name:MCCLOY, ROBERT B JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:MCCLOY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 CHARING CROSS CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3201
Mailing Address - Country:US
Mailing Address - Phone:405-329-8648
Mailing Address - Fax:
Practice Address - Street 1:3901 CHARING CROSS CT
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3201
Practice Address - Country:US
Practice Address - Phone:405-329-8648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8876207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE77682Medicare UPIN