Provider Demographics
NPI:1356664817
Name:MCCLUNG, WILLIAM A (APRN)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:MCCLUNG
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:MCCLUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12234 PANAMA CITY BEACH PKWY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-2725
Mailing Address - Country:US
Mailing Address - Phone:850-233-2323
Mailing Address - Fax:850-233-1055
Practice Address - Street 1:12234 PANAMA CITY BEACH PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-2725
Practice Address - Country:US
Practice Address - Phone:850-233-2323
Practice Address - Fax:850-233-1055
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9249100207Q00000X, 363LF0000X
FLRN9249100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health