Provider Demographics
NPI:1659311694
Name:MCLEAN, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8234 JEFFERSON PAIGE RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71119
Mailing Address - Country:US
Mailing Address - Phone:318-638-8114
Mailing Address - Fax:318-638-8114
Practice Address - Street 1:7045 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5108
Practice Address - Country:US
Practice Address - Phone:318-798-3763
Practice Address - Fax:318-798-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2010-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA019455207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine