Provider Demographics
NPI:1003528407
Name:MCCLAIN, JAMON
Entity Type:Individual
Prefix:MR
First Name:JAMON
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 WILLET AVE SE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707-3894
Mailing Address - Country:US
Mailing Address - Phone:330-267-8238
Mailing Address - Fax:
Practice Address - Street 1:1471 WILLET AVE SE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707-3894
Practice Address - Country:US
Practice Address - Phone:330-267-8238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator