Provider Demographics
NPI:1063774347
Name:MCLAWHORN, MARC CARPENTER (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:CARPENTER
Last Name:MCLAWHORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:350 W THOMAS RD
Mailing Address - Street 2:SURGICAL SUITE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013
Mailing Address - Country:US
Mailing Address - Phone:602-406-3541
Mailing Address - Fax:602-406-7135
Practice Address - Street 1:350 W THOMAS RD
Practice Address - Street 2:SURGICAL SUITE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-406-3541
Practice Address - Fax:602-406-7135
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL34793208600000X, 207L00000X
AZ54272207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery