Provider Demographics
NPI:1619359767
Name:MCARTHUR, CLIFFORD (MS, RDN, CSSD)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:
Last Name:MCARTHUR
Suffix:
Gender:M
Credentials:MS, RDN, CSSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 N 2ND W APT 3B
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-2602
Mailing Address - Country:US
Mailing Address - Phone:253-720-8595
Mailing Address - Fax:
Practice Address - Street 1:NUTRITION AND DIETETICS, 366TH MEDICAL GROUP
Practice Address - Street 2:90 HOPE DRIVE
Practice Address - City:MOUNTAIN HOME AFB
Practice Address - State:ID
Practice Address - Zip Code:83648
Practice Address - Country:US
Practice Address - Phone:288-208-1238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management