National Provider Identifier
Dallin Bruce McClanahan, PA
Dallin Bruce McClanahan, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Rochester, NY and a listed phone number of (585) 922-4840.
Profile Overview
- NPI
- 1467032573
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- April 12, 2021
- Last Updated
- September 24, 2021
Practice Location
- 1425 Portland Ave
- Rochester, NY 14621-3011
Phone: (585) 922-4840
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Surgical Physician Assistant (363AS0400X)
Full Record
- NPI
- 1467032573
- Entity Type
- Individual
- Last Name
- McClanahan
- First Name
- Dallin
- Middle Name
- Bruce
- Credential
- PA
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (585) 922-4840
- Mailing Fax
- (585) 922-3950
- Practice Street Address
- 1425 Portland Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3011
- Practice Country
- US
- Practice Phone
- (585) 922-4840
- Practice Fax
- (585) 922-3950
- Enumeration Date
- April 12, 2021
- Last Updated
- September 24, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 24, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X)