Provider Demographics
NPI:1770550527
Name:MCCLUSKY, CHRISTINE M (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:MCCLUSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6730
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6730
Mailing Address - Country:US
Mailing Address - Phone:480-821-3600
Mailing Address - Fax:480-821-3610
Practice Address - Street 1:2055 W FRYE RD STE 9
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6277
Practice Address - Country:US
Practice Address - Phone:480-821-3600
Practice Address - Fax:480-857-2667
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3163207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ362814Medicaid
AZBM2824224OtherDEA CERTIFICATE
F93998Medicare UPIN
AZBM2824224OtherDEA CERTIFICATE