Provider Demographics
NPI:1447745245
Name:ST. CLAIR, DEVIN DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:DEAN
Last Name:ST. CLAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3900 N PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6398
Mailing Address - Country:US
Mailing Address - Phone:479-966-4187
Mailing Address - Fax:479-966-4197
Practice Address - Street 1:3900 N PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6398
Practice Address - Country:US
Practice Address - Phone:479-966-4187
Practice Address - Fax:479-966-4197
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-17844207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2018021042OtherBNDD