Provider Demographics
NPI:1669511929
Name:MCCLAIN, CHAD A (CRNA)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:A
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 W CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-4020
Mailing Address - Country:US
Mailing Address - Phone:256-318-8155
Mailing Address - Fax:
Practice Address - Street 1:1874 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5514
Practice Address - Country:US
Practice Address - Phone:256-301-3340
Practice Address - Fax:256-301-3444
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-103929367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-103929OtherSTATE LICENSE NUMBER