Provider Demographics
NPI:1427024173
Name:MCLEAN, WILLIAM STARR (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STARR
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:DO
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 657
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-0657
Mailing Address - Country:US
Mailing Address - Phone:706-839-4096
Mailing Address - Fax:706-839-4097
Practice Address - Street 1:247 ADAMS DRIVE
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-3053
Practice Address - Country:US
Practice Address - Phone:706-839-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025637207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000271763AMedicaid
GAD46094Medicare UPIN