Provider Demographics
NPI:1639175177
Name:MCLAREN, ROXY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROXY
Middle Name:
Last Name:MCLAREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E 11TH ST
Mailing Address - Street 2:STE 204
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4363
Mailing Address - Country:US
Mailing Address - Phone:712-262-3795
Mailing Address - Fax:
Practice Address - Street 1:116 E 11TH ST
Practice Address - Street 2:STE 204
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4363
Practice Address - Country:US
Practice Address - Phone:712-262-3795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21273207ZP0102X
TXF4954207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN642398100Medicaid
A03936Medicare UPIN