Provider Demographics
NPI:1790954055
Name:JAMES H MCCLAIN
Entity Type:Organization
Organization Name:JAMES H MCCLAIN
Other - Org Name:MIDWEST FOOT & ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:269-651-1038
Mailing Address - Street 1:68689 VINEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-8896
Mailing Address - Country:US
Mailing Address - Phone:269-651-1038
Mailing Address - Fax:269-659-8276
Practice Address - Street 1:68689 VINEWOOD AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-8896
Practice Address - Country:US
Practice Address - Phone:269-651-1038
Practice Address - Fax:269-659-8276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJM001119332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2730007OtherIBA/PHP
MI5752048OtherBLUE CARE NETWORK
MI5752048OtherBCBS OF MICHIGAN
MI013007OtherUHC/UNITED HEALTHCARE
MI1537307Medicaid
MI5755028Medicare PIN
MI013007OtherUHC/UNITED HEALTHCARE
MI2730007OtherIBA/PHP