Provider Demographics
NPI:1659149144
Name:MCLENDON, DIJON M
Entity Type:Individual
Prefix:
First Name:DIJON
Middle Name:M
Last Name:MCLENDON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2552
Mailing Address - Country:US
Mailing Address - Phone:419-442-9823
Mailing Address - Fax:
Practice Address - Street 1:612 SPRING ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2552
Practice Address - Country:US
Practice Address - Phone:419-442-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker