Provider Demographics
NPI:1043301153
Name:JAMES Q. MCCLELLAND, DPM, PPC
Entity Type:Organization
Organization Name:JAMES Q. MCCLELLAND, DPM, PPC
Other - Org Name:ARDMORE FOOT AND ANKLE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-223-0718
Mailing Address - Street 1:2002 12TH AVE NW
Mailing Address - Street 2:SUITE F
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1227
Mailing Address - Country:US
Mailing Address - Phone:580-223-0718
Mailing Address - Fax:580-223-0719
Practice Address - Street 1:2002 12TH AVE NW
Practice Address - Street 2:SUITE F
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1227
Practice Address - Country:US
Practice Address - Phone:580-223-0718
Practice Address - Fax:580-223-0719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty