Basic Information
Provider Information
NPI: 1558710897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCLAIN
FirstName: THOMAS
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4665 DOUGLAS CIR NW STE 100
Address2:  
City: CANTON
State: OH
PostalCode: 447183673
CountryCode: US
TelephoneNumber: 3304995700
FaxNumber: 3304984229
Practice Location
Address1: 29000 CENTER RIDGE RD
Address2:  
City: WESTLAKE
State: OH
PostalCode: 441455219
CountryCode: US
TelephoneNumber: 4407099150
FaxNumber: 4405790191
Other Information
ProviderEnumerationDate: 06/07/2016
LastUpdateDate: 05/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X34.014561OHY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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