Provider Demographics
NPI:1609518976
Name:THE DOWN UNDER CLINIC PC
Entity Type:Organization
Organization Name:THE DOWN UNDER CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-707-9504
Mailing Address - Street 1:PO BOX 10356
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85318-0356
Mailing Address - Country:US
Mailing Address - Phone:480-707-9504
Mailing Address - Fax:602-581-7764
Practice Address - Street 1:7776 W QUAIL AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3322
Practice Address - Country:US
Practice Address - Phone:602-421-1299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty