Provider Demographics
NPI:1700906559
Name:MCCLURE, KATHRYN ANNE (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2934
Mailing Address - Country:US
Mailing Address - Phone:504-885-6060
Mailing Address - Fax:504-887-2114
Practice Address - Street 1:4720 S I 10 SERVICE RD
Practice Address - Street 2:#502
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-885-6060
Practice Address - Fax:504-887-2114
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD023772207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H39355Medicare UPIN