Provider Demographics
NPI:1922021807
Name:DR. JAMES A. MCCLELLAN, P.C.
Entity Type:Organization
Organization Name:DR. JAMES A. MCCLELLAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-392-6136
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-0608
Mailing Address - Country:US
Mailing Address - Phone:434-392-6136
Mailing Address - Fax:434-392-7408
Practice Address - Street 1:420 E 3RD ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1512
Practice Address - Country:US
Practice Address - Phone:434-392-6136
Practice Address - Fax:434-392-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty