Provider Demographics
NPI:1760425078
Name:MACKLIN, JAMES EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:MACKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3555 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 3070
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3912
Mailing Address - Country:US
Mailing Address - Phone:614-566-2942
Mailing Address - Fax:614-566-6886
Practice Address - Street 1:85 MCNAUGHTEN ROAD
Practice Address - Street 2:SUITE 130
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:614-577-8322
Practice Address - Fax:614-577-8302
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35041210207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0434499Medicaid
OH4800038OtherUHC
OH000000118566OtherANTHEM
OH0434499Medicaid
OH0494825Medicare PIN
OH0494824Medicare PIN