Provider Demographics
NPI:1174689210
Name:MCCLINTIC, JAMES ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ARNOLD
Last Name:MCCLINTIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1830
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-1830
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:
Practice Address - Street 1:1201 5TH AVE N
Practice Address - Street 2:SUITE 408
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1400
Practice Address - Country:US
Practice Address - Phone:727-894-3733
Practice Address - Fax:727-825-1482
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00860651OtherRAILROAD MEDICARE PROVIDER NUMBER
FL002822000Medicaid
F44113Medicare UPIN
FL002822000Medicaid