Provider Demographics
NPI:1376689901
Name:MCCORD, CLINTON D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:D
Last Name:MCCORD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 DOWNWOOD CIR NW
Mailing Address - Street 2:SUITE 640
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1610
Mailing Address - Country:US
Mailing Address - Phone:404-351-0051
Mailing Address - Fax:678-420-7056
Practice Address - Street 1:3200 DOWNWOOD CIR NW
Practice Address - Street 2:SUITE 640
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1610
Practice Address - Country:US
Practice Address - Phone:404-351-0051
Practice Address - Fax:678-420-7056
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA0095482082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD40592Medicare UPIN