Mcclane, John W

Mcclane, John W is an individual health care provider with primary practice located at 6 South 14Th Street , Fernandina Beach FL 32034. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mcclane, John W can be contacted via phone (904) 261-5741.

Contact Information

Primary practice address
6 South 14Th Street Fernandina Beach FL 32034
Fax: (904) 261-7383
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 887 Georgia
Eye and Vision Services Providers / Optometrist 152W00000X 1488 Florida

Profile Details

NPI number 1366529075
LBN Legal business name Mcclane, John W
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jan 7th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366529075 NPPES
Georgia MEDICAID 00261797C
Georgia MEDICAID 00243911B
Georgia MEDICAID 00254141B
Georgia MEDICAID 959951220A

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